目的:干眼已成为影响儿童和青少年眼健康的重要问题,但其流行病学特征及相关因素尚未在中国西部地区儿童和青少年群体中得到充分研究。本研究旨在调查新疆喀什地区英吉沙县学龄儿童和青少年的干眼患病率,并分析其相关因素,为儿童和青少年干眼的防治提供流行病学依据。方法:本研究为横断面研究,于2024年5—6月在英吉沙县第三中学和芒辛镇中心小学开展,共纳入3 305名在校儿童和青少年进行问卷调查,并随机抽取557名儿童和青少年进行眼表检查。采用眼表综合分析仪测量泪河高度和非接触泪膜破裂时间。干眼诊断基于世界泪膜与眼表学会发布的第二版干眼专家共识(2017)。采用多因素logistic回归分析干眼的相关因素。结果:在557名参与儿童和青少年中,干眼患病率为16.88%(94/557)。不同性别间干眼患病率比较差异无统计学意义(P=0.81)。干眼患病率随年龄增长而增加,具有显著的线性趋势。任一眼有屈光不正的儿童和青少年干眼患病率更高(29.05% vs. 12.47%,P<0.001)。多因素Logistic回归分析显示年龄(OR=1.21)和屈光不正(OR=2.72)是干眼的危险因素,性别、身体质量指数、右眼眼轴长度及父母近视情况无关。结论:新疆喀什地区英吉沙县学龄儿童和青少年的干眼患病率与全国均值相近且偏低,年龄增长和屈光不正显著增加干眼患病风险,应关注儿童和青少年屈光状态对眼表健康的影响,并采取相应的预防措施。
Objective: Dry eye (DED) has emerged as an important ocular health concern among children and adolescents. However, in pediatric populations in western China, its epidemiological characteristics and associated risk factors have not been thoroughly investigated. This study aimed to investigate the prevalence of DED and analyze its risk factors among school-age children and adolescents in Yingjisha County, Kashgar Prefecture, Xinjiang, so as to provide a solid evidence base for formulating prevention and control strategies. Methods: This cross-sectional study was conducted from May to June 2024 at Yingjisha County No. 3 Middle School and Mangxin Central Primary School. A total of 3,305 school children and adolescents completed the questionnaire, and 557 of them were randomly selected for ocular surface examinations. The Keratograph 5M was used to measure tear meniscus height (TMH) and non-invasive tear break-up time (NIBUT). DED diagnosis adhered to the Dry Eye WorkShop II 2017 (DEWS II) criteria published by Tear Film & Ocular Surface Society (TFOS). Multivariate logistic regression was applied to evaluate the associated risk factors. Results: Among the 557 children and adolescents who underwent examinations, the prevalence of DED was 16.88% (94/557). No statistically significant difference was observed between genders (P = 0.81). The prevalence of DED increased with age, showing a significant linear trend. Participants with refractive errors in either eye had a significantly higher prevalence of DED (29.05% vs. 12.47%, P< 0.001). Logistic regression analysis identified age (OR = 1.21) and refractive error (OR = 2.72) as risk factors. No significant associations were found for gender, Body Mass Index (BMI), axial length of the right eye, or parental myopia. Conclusions: The prevalence of DED among school-age children and adolescents in Yingjisha County is either comparable to or slightly lower than, the national average. Age and refractive error substantially increase the risk of DED. Greater attention should be directed towards children’s refractive status to protect ocular surface health and implement early preventive measures.
朗格汉斯细胞组织细胞增生症 (Langerhans cell histiocytosis,LCH) 是一种由骨髓细胞肿瘤性增殖引起的罕见疾病,多见于儿童。LCH临床表现多样,以骨骼受累最常见。该文报道了一例儿童颅眶沟通LCH,影像学检查结果提示患儿右侧眉弓处类圆形穿凿样骨质破坏,通过手术切除病灶,送组织病理学检查明确诊断,同时选择通过3D打印聚醚醚酮(polyetheretherketone,PEEK)材料修补颅眶缺损部位,PEEK材料匹配度高、安全性好,改善患儿预后,提升患儿生存质量。
Langerhans cell histiocyte (LCH) is a rare disease caused by the tumor-like proliferation of bone marrow cells, which is mostly seen in children. Its clinical manifestations can be diverse, in which the skeletal system is most involved. This paper reports a case of LCH in cranio-orbital communication of a child. The imaging results suggest that there is a round chisel damage at the patient’s right brow ridge. In terms of definitive diagnosis and treatment, this patient underwent surgical resection and histopathological examination. 3D-printed polyether-ether-ketone (PEEK) material was selected to repair the cranio-orbital defect. The material can achieve better biocompatibility, while 3D-printing technique allows higher matching degree, both help to improve the prognosis and quality of life of the patient.
干眼为最常见的眼表疾病之一,以泪膜稳态丢失及伴随眼部症状为特征。干眼的治疗以消除病因、缓解症状和保护视功能为目标,而其中的心理护理、眼睑物理治疗、健康宣教和院外管理尤为重要。优质的整体护理方案有助于干眼患者的治疗。本团队在参考干眼诊疗共识的基础上,结合自身护理经验,为干眼患者制定了个性化、涵盖全面的整体护理方案并运用。
Dry eye is one of the most common ocular surface diseases, characterized by a loss homeostasis of tear film,and accompanied by ocular symptoms. The treatment of dry eye aims to eliminate the cause of disease, relieve symptoms, and protect the visual function, among which psychological care, physical treatment of eyelid, health education and management outside the hospital are particularly important. High quality holistic nursing plan is helpful to the treatment of dry eye patients. Based on the consensus of the diagnosis and treatmen of dry eye,combined with our nursing experience, our team has developed and applied a personalized and comprehensive holistic nursing plan for dry eye patients.
干眼是以泪膜稳态丢失及伴随眼部不适症状为特征的最常见眼表疾病,泪膜不稳定、泪液高渗透性、眼表炎症及感觉神经异常为其主要病因。地夸磷索钠是一种P2Y2受体激动剂,能刺激黏蛋白及泪液分泌,其独特的作用机制为干眼的治疗开辟了新的方向,本文就地夸磷索钠近年的临床及基础研究进展作一综述。
Dry eye is one of the most common ocular surface diseases. It is characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and tear hyperosmolarity, ocular surface inflammation, and neurosensory abnormalities play major etiological roles. Diquafosol tetrasodium is a purinergic P2Y2 receptor agonist that promotes mucin and aqueous tear secretion. The unique pharmacological mechanism of diquafosol tetrasodium opens up a new direction for the medical therapies of dry eye. This article reviews the clinical therapeutic effect and research progress of diquafosol tetrasodium for the past few years.