中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
12期
1649-1652
,共4页
吴红云%易长贤%杨莎莎%练苹
吳紅雲%易長賢%楊莎莎%練蘋
오홍운%역장현%양사사%련평
急性视网膜坏死综合征%诊断%误诊%对策
急性視網膜壞死綜閤徵%診斷%誤診%對策
급성시망막배사종합정%진단%오진%대책
Acute retinal necrosis syndrome%Diagnosis%Misdiagnosis%Countermeasure
目的 分析急性视网膜坏死综合征(Acute retinal necrosis syndrom,ARN)误诊的原因,探讨防止误诊的对策.方法 收集2006年5月至2012年5月在中山大学中山眼科中心确诊并住院治疗81例(93只眼)ARN患者的临床病史资料,并对临床资料进行回顾性分析.结果 81例患者发病至初诊时间1～21天不等,平均7.03天,发病至正确诊断为ARN的时间为5～280天不等,平均31.11天;初次就诊确诊病例7例7只眼,多次就诊后确诊病例74例86只眼,误诊率91.36％; 74例误诊病例中1次误诊后确诊病例22例,占29.73％,2次误诊后确诊病例35例,占47.30％,3次及以上误诊后确诊病例17例,占22.97％; 86只误诊眼中误诊为葡萄膜炎55只眼占63.95％,其中明确误诊为虹膜睫状体炎的27只眼占31,40％,误诊为其他无明确类型的葡萄膜炎28只眼占32.56％;另外误诊为结膜炎的15只眼占17.44％,误诊为青光眼的3只眼占3.49％,误诊为视网膜炎、视网膜静脉炎、视网膜动脉阻塞及视网膜出血的共13只眼占15.12％.结论 ARN是高误诊率高、致盲率的眼部疾病,加强各级医务人员对ARN的认识,提高诊疗水平,刻不容缓.
目的 分析急性視網膜壞死綜閤徵(Acute retinal necrosis syndrom,ARN)誤診的原因,探討防止誤診的對策.方法 收集2006年5月至2012年5月在中山大學中山眼科中心確診併住院治療81例(93隻眼)ARN患者的臨床病史資料,併對臨床資料進行迴顧性分析.結果 81例患者髮病至初診時間1～21天不等,平均7.03天,髮病至正確診斷為ARN的時間為5～280天不等,平均31.11天;初次就診確診病例7例7隻眼,多次就診後確診病例74例86隻眼,誤診率91.36％; 74例誤診病例中1次誤診後確診病例22例,佔29.73％,2次誤診後確診病例35例,佔47.30％,3次及以上誤診後確診病例17例,佔22.97％; 86隻誤診眼中誤診為葡萄膜炎55隻眼佔63.95％,其中明確誤診為虹膜睫狀體炎的27隻眼佔31,40％,誤診為其他無明確類型的葡萄膜炎28隻眼佔32.56％;另外誤診為結膜炎的15隻眼佔17.44％,誤診為青光眼的3隻眼佔3.49％,誤診為視網膜炎、視網膜靜脈炎、視網膜動脈阻塞及視網膜齣血的共13隻眼佔15.12％.結論 ARN是高誤診率高、緻盲率的眼部疾病,加彊各級醫務人員對ARN的認識,提高診療水平,刻不容緩.
목적 분석급성시망막배사종합정(Acute retinal necrosis syndrom,ARN)오진적원인,탐토방지오진적대책.방법 수집2006년5월지2012년5월재중산대학중산안과중심학진병주원치료81례(93지안)ARN환자적림상병사자료,병대림상자료진행회고성분석.결과 81례환자발병지초진시간1～21천불등,평균7.03천,발병지정학진단위ARN적시간위5～280천불등,평균31.11천;초차취진학진병례7례7지안,다차취진후학진병례74례86지안,오진솔91.36％; 74례오진병례중1차오진후학진병례22례,점29.73％,2차오진후학진병례35례,점47.30％,3차급이상오진후학진병례17례,점22.97％; 86지오진안중오진위포도막염55지안점63.95％,기중명학오진위홍막첩상체염적27지안점31,40％,오진위기타무명학류형적포도막염28지안점32.56％;령외오진위결막염적15지안점17.44％,오진위청광안적3지안점3.49％,오진위시망막염、시망막정맥염、시망막동맥조새급시망막출혈적공13지안점15.12％.결론 ARN시고오진솔고、치맹솔적안부질병,가강각급의무인원대ARN적인식,제고진료수평,각불용완.
Objective To analyze the causes of misdiagnosis of acute retinal necrosis syndrome (ARN),and possible critical points in preventing misdiagnosis.Methods Clinical data of 81 cases (93 eyes) in-patients with ARN from May 2006 to May 2012 in Zhongshan Ophthalmic Center,Sun Yat-sen University were retrospectively analyzed.Results The average time of first visit after appearance of ocular symptoms was 7.03 days (1 to 21 days),86 eyes (91.36％) was misdiagnosed in total.There were only 7 eyes that were correctly diagnosed at initial ophthalmic consultation.It took 31.11 days (ranging from 5 to 280 days) to reach the correct diagnose.Among the misdiagnosed eyes,22 eyes (29.73％) experienced one time misdiagnosis,35 eyes (47.3％) twice and 17 eyes (22.97％) had correctly diagnosis after three or even more time of ophthalmic examinations.Of the 86 misdiagnosed eye,55 eyes (63.95％) was labeled as uveitis,27 eyes (31.40.％) as kidocyclitis,28 eyes (32.55％) as other without explicit type of uveitis.Fifteen eyes (17.44％) were as conjunctivitis and 3 eyes (3.49％) as glaucoma and 13 eyes (15.12％) as others such as retinitis,Eales disease,retinal artery occlusion and retinal hemorrhage.Conclusions ARN is a easily misdiagnosed severe eye diseases.Ophthalmic professional have be alert when come across various uveitis and retinal diseases.
