儿童Munchausen综合征一例

Munchausen syndrome in a child

1例6岁半女童因双眼“白色分泌物”2周曾在多家医院治疗无效后转诊于西安交通大学第一附属医院眼科。患儿拒绝与医师交流和进行详细检查,眼部检查仅见双眼结膜充血,依据患儿家长提供的双眼“白色分泌物”照片和自行收集的“白色分泌物”,诊断为双眼结膜炎和结膜异物待查。在医师的提醒、家长的严密观察和耐心沟通下,患儿承认自己是为获得家长关注将纸巾碎片放入眼内。请心理科会诊后诊断为Munchausen综合征。给予结膜炎对症治疗和改善家庭环境,患儿病情好转。

A six-and-a-half-year-old girl with white secretions in her eyes for 2 weeks was treated in the Ophthalmology Department of the First Affiliated Hospital of Xi′an Jiaotong University after ineffective treatment in several hospitals.The patient refused to communicate with the doctor and receive detailed examination.Only conjunctival congestion was found in both eyes.According to the photos and specimens of white secretions from both eyes provided by the parents of the patient,the diagnosis was conjunctivitis and conjunctival foreign bodies.With the doctor′s reminding,the parents did close observation and good communication.The child finally admitted that she had put tissue fragments into her eyes in order to attract the parents′attention.Munchausen syndrome was diagnosed by a psychiatrist.After symptomatic treatment and improvement of family environment,the patient′s condition improved.