患者,男性,1岁9个月。以“发现右眼上、下眼睑肿物25 d”首诊于眼科,要求切除,但经影像学及病理学检查,诊断为多发性朗格汉斯细胞组织细胞增生症,且全身骨骼多处出现溶骨性改变,不符合切除指征。给予多次全身化学治疗后眼部肿物明显变小。该例诊治提醒眼科医生,眼部肿物可由全身系统性疾病引起,不可盲目切除,必要时做进一步检查。术中切除物均建议行病理活组织检查,以免延误治疗。
patient, male, 1year and 9months old, was first diagnosed as “eye tumor” in the ophthalmology department and requested for excision. But it was diagnosed as multiple Langerhans cell histiocytosis (LCH) through imaging and pathological examination ultimately.Bone lytic changes appeared in many parts of the whole body, which did not meet the indication of excision.The tumor was smaller after systemic chemotherapy. The diagnosis and treatment of this case suggests ophthalmologists that eye tumors can be caused by caused by systemic diseases, systemic diseases. During operation, it is recommended to perform pathological biopsy to avoid treatment delay.
目的:探讨先天性鼻泪管阻塞的临床治疗效果。方法:选取在咸阳彩虹医院接受治疗并有随诊记录的先天性鼻泪管阻塞患儿共630例(827眼)。根据年龄大小,采用4种方式统计治疗效果。结果:年龄0~2个月患儿230例(286眼),选取泪囊按摩和局部点抗炎眼水治疗,182眼(63.63%)治愈;2~6个月患儿240例(340眼),选取加压冲洗或泪道探通术治疗,338眼(96.74%)治愈;6~12个月患儿150例(188眼),选取泪道冲洗+泪道探通术治疗,188眼(89.74%)治愈;1岁以上患儿10例(13眼),选取泪道探通术加局部抗炎治疗,10眼(76.92%)治愈。结论:2~6个月是先天性鼻泪管阻塞治疗的最佳时间,泪道冲洗加探通技术在治疗婴幼儿先天性鼻泪管阻塞创伤小,疗效肯定,远期复发率低。
Objective: To discuss the therapeutic effects of congenital nasolacrimal duct obstruction. Methods: A total of 630 children (827 eyes) with congenital nasolacrimal duct obstruction who were treated in Xianyang Rainbow Hospital and had follow-up records were selected. According to the age, the therapeutic effects were carried out in four ways. Results: A total of 230 cases (286 eyes) aged 0–2 months were treated by massaging lacrimal sac withantiinflammatory eye water, 182 eyes (63.63%) were healed; 240 cases (340 eyes) aged 2–6 months were treated by pressor clysis and lacrimal passages probing, and among them 338 eyes (96.74%) were healed. 150 cases (188 eyes) aged 6–12 months were treated with lacrimal passage irrigation and lacrimal passage probing. 188 eyes (89.74%) were cured; 10 cases (13 eyes) aged over 1 year old were tread by probing of the lacrimal passages with anti-inflammatory eye water, 10 eyes (76.92%) were healed. Conclusion: 2 to 6 months is the best time for the treatment of congenital nasolacrimal duct obstruction, the therapy of pressor clysis with lacrimal passages probing chosen according to the age can treat the congenital nasolacrimal duct obstruction efficiently and decrease the long-term recurrence