外伤性睫状体脱离漏诊和误诊分析

Analysis of the problems in the clinical missed and inaccurate diagnosis of traumatic ciliary detachment

目的分析外伤性睫状体脱离临床诊断中存在的问题及误诊的主要原因。方法回顾性分析20例(20只眼)外伤性睫状体脱离患者的临床资料。对所有患者详细询问病史,进行双眼裂隙灯显微镜、间接眼底镜、视力、眼压、房角镜及UBM检查,探讨外伤性睫状体脱离在临床中漏诊和误诊的主要原因。结果20例(20只眼)外伤性睫状体脱离患者中,初诊被误诊为外伤性视网膜病变者8例,中心性浆液性脉络膜视网膜病变者7例,视盘水肿者4例,近视者1例。结论外伤性睫状体脱离在临床诊断中容易造成误诊和漏诊,病史询问不详细,未能全面掌握外伤性睫状体脱离临床表现及其特点是发生漏诊和误诊的主要原因。

Objective To analyze the problems in the diagnosis of traumatic ciliary detachment and its main causes of misdiagnosis. Methods The clinical data of 20 cases （20 eyes） with traumatic ciliary detachment undergone siltlamp microscopy, indirect ophthalmoscopy, visual acuity, intro-ocular tension, gonioscopy, UBM and follow-up examination were retrospectively analyzed. The disease history of each patient was carefully recorded and inrestgate the reasons of missed and inaccurate diagnosis of traumatic ciliary detachment. Results In 20 patients （ 20 eyes）, there were 8 cases （ 8 eyes ） whose initial diagnosis was traumatic retinopathy in 8 cases; central retinopathy in 7 ; opticdisc vasculitis in 4; brachymetropia in 1. Conclusions There are many problems in the clinical diagnosis of traumatic ciliary detachment. The main reason of misdiagnosis is that the clinicians can not record the disease history of each patient carefully enough and can not comprehensively master the clinical manifestations of traumatic ciliary detachment and its clinical characters.