结核性脑膜炎继发眼部并发症临床分析

Clinical Analysis of Eye Complications Secondary to Tuberculous Meningitis

目的探讨结核性脑膜炎继发眼部并发症的常见类型及对视功能的影响。方法2008年8月至2012年5月在本院结核病研究所确诊结核性脑膜炎住院患者，因继发眼部并发症来眼科会诊132例，男73例，女59例，平均年龄28.3（11~58）岁。了解眼部并发症的种类以及对视功能的影响。结果132例结核性脑膜炎患者中继发眼外肌麻痹24例（18.2%）、虹膜睫状体炎20例（15.2%）、全葡萄膜炎17例（12.9%）、视盘水肿18例（13.6%）、视神经萎缩14例（10.6%）、黄斑水肿28例（21.2%）、白内障11例（8.3%）；132例结核性脑膜炎患者中出现复视24例（18.1%）、视力下降103例（78%）、虹膜粘连26例（19.7）、玻璃体混浊29例（22%）、视野异常75例（56.8%）。结论结核性脑膜炎的眼部并发症不容忽视，当患者脱离了生命危险，处于逐渐恢复期时，眼部并发症造成的损害就突显出来。视野异常、视功能障碍、复视等会严重影响患者生存质量。

Obj ective]To explore the common eye complications secondary to tuberculous meningitis and their effect on visual function.[Methods]The patients were chosen from the inpatients diagnosed as tubercu-lous meningitis in our institute for tuberculosis from Aug.2008 to May 2012.Among 132 patients with eye complications secondary to tuberculous meningitis,73 patients were male and 59 patients were female.Their average age was 28.3 years old（11~58 years old）.The types of eye complications and their effect on visual function were discussed.[Results]Of 132 patients with tuberculous meningitis,24 patients had secondary ex-traocular palsy（18.2%）,and 20 patients had iridocyclitis（15.2%）,and 17 patients had panuveitis（12.9%）, and 18 patients had papilledema（13.6%）,and 14 patients had optic atrophy（10.6%）,and 28 patients had macular edema（21.2%）,and 11 patients had cataract（8.3%）.Among all the patients,diplopia,impaired vi-sion,synechia,vitreous opacities and abnormal visual field occurred in 24 patients（18.1%）,103 patients （78%）,26 patients（19.7%）,29 patients（22%）and 75 patients（56.8%）,respectively.[Conclusion]Eye complications secondary to tuberculous meningitis should not be ignored.When patients are broken away from critical condition and recovered gradually,the damage induced by eye complications becomes apparent.Abnor-mal visual field,visual impairment and diplopia will seriously affect the quality of life in patients.