原发性青光眼患者确诊途径调查

An investigation for the events that led the glaucoma patients to the hospital

目的了解何种原因使得原发性青光眼患者到医院就诊,最终青光眼得以诊断。设计以医院为基础的问卷调查。研究对象 287例已确诊为原发性青光眼的连续患者。方法设计一组问题,对本组青光眼患者进行以医院为基础的问卷调查,问卷内容主要包括患者首次被诊断青光眼的医院;患者到眼科寻医的原因;患者求治的主要症状;以及其青光眼被诊断的主要依据。主要指标统计分析患者寻医的主要原因和症状,以及患者所了解的主要诊断依据。结果视力下降(87．7％),眼痛 (80．8％)和眼红是急性闭角型青光眼患者求医的原因。在慢性闭角型青光眼和开角型青光眼,分别有39．7％和46．2％的病例主诉有视力问题,部分患者主诉有眼部症状,但这些症状多与青光眼无关,约25％的患者没有任何症状。71％(205／287)的患者认为眼压升高对青光眼诊断最为关键。在慢性闭角型青光眼和开角型青光眼中,75％的病例在确诊时,至少有1眼已属于青光眼中晚期。结论急性闭角型青光眼因症状明显,常引导患者主动就诊。慢性闭角型青光眼和开角型青光眼早期多无症状,他们得以诊断的原因是因为其他非青光眼症状,或有青光眼家族史而到医院检查,或常规体检发现了青光眼。

Purpose To investigate the triggers that referred the patients to hospital, so that the diagnosis of glaucoma was identified. Design Hospital-based questionnaire survey. Participants 287 consecutive primary glaucoma patients. Methods A questionnaire was administered to the patients. The questions included which hospital the patient was diagnosed initially, the reason that led the patient to hospital, the main ocular symptoms that the patient complained, and the most inpressive abnormality left to the patient, etc. Main Outcome Measures The main reason and the symptom that led the patient to hospital, and the patient＇s deepest impression on glaucoma. Results Decreased vision （87.7%）, ocular pain （80.8%） and bulhar hyperemia （78.1%） were the most common events that acute angle-closure glaucoma patients sought medical help. 39.7% of 136 patients with chronic angle-closure glaucoma and 46.2% of 78 patients with open angle glaucoma had decreased visions. Glaucoma was most frequently found due to patients come to realize some symptoms on themselves, although the symptoms were infrequently related to glaucoma. 25% of the patients had no any ocular symptom. Seventy-one of glaucoma patients （205 of 287） recalled elevated intraocular pressure （IOP） as the most important abnormality for their initial diagnosis. 75% of the patients with chronic angle-closure glaucoma or open angle glaucoma were identified as middle or late stage of glaucoma at least one eye at the diagnostic visit. Conclusions Because of the typical symptoms, the patients with acute angle-closure glaucoma could be diagnosed timely. In the early stage, chronic angle-closure glaucoma and open angle glaucoma might not have any symptom until the advanced stage, they were most frequently found due to some irrelevant symptoms, routine examinations, or having a positive family history. （Ophthalmol CHN , 2006, 15：54-58）