容易误诊的儿童隐匿性角膜异物临床报告

Easily Misdiagnosed Children with Concealed Corneal Foreign Body:a Case Report

目的探讨儿童隐匿性角膜异物的临床特点及误诊原因、防范措施。方法对曾误诊的儿童隐匿性角膜异物8例的临床资料进行回顾性分析。结果本组误诊率17.8%,年龄5个月~16岁,皆有反复眼红表现,均曾误诊为角膜炎,给予相应治疗效果不佳。误诊时间3 d^2个月。入我院后根据眼红反复发作、角膜刺激症状及详细裂隙灯检查并荧光素染色后确诊为隐匿性角膜异物,均行角膜异物取出术,术后恢复良好。门诊复查2个月,均未再出现眼红。结论隐匿性角膜异物易误诊。临床接诊眼红反复发作、畏光、流泪、异物感或眼科检查角膜炎症浸润、溃疡混浊、透明度局部下降且久治不愈者应警惕隐匿性角膜异物。

Objective To investigate clinical features,misdiagnosed causes and preventive measures of children withconcealed corneal foreign body. Methods Clinical data for 8 misdiagnosed children with concealed corneal foreign body wasretrospectively analyzed. Results The misdiagnosed rate was 17. 8% in this study,and patients＇ age range from 5 months to16 years old. All children had repeatedly redeye,and had been misdiagnosed as having keratitis,but the effects were poor bycorresponding treatments. Misdiagnosed time was 3 d2 months. Concealed corneal foreign body was confirmed by redeye recurrent attacks,corneal irritation,careful slit lamp examination and staining,and foreign body was removed. The children recovered well after the surgery without redeye symptom during 2 months of review. Conclusion Concealed corneal foreignbody is easy to be misdiagnosed. The patients should be highly suspected as having concealed corneal foreign body with symptoms of repeatedly redeye symptom,photophobia,lacrimation,foreign body sensation or with corneal inflammatory infiltration,ulcer turbidity,local opacity in eye examinations and longterm incurability.