多灶性脉络膜炎伴全葡萄膜炎临床表现与治疗探讨.docVIP

多灶性脉络膜炎伴全葡萄膜炎临床表现与治疗探讨 　　【摘要】 目的：探析多灶性?}络膜炎伴全葡萄膜炎的临床表现与治疗方式。方法：以笔者所在医院收治的1例患者为研究对象，该患者为笔者所在科2016年11月28日收治，双眼反复红痛同时视力下降3年，视力下降前双眼反复红痛，无明显诱因。随着病情进展病灶渐变为边界整齐、色素萎缩性瘢痕，同时还有视盘水肿及充血等现象。患者共入院3次，每次病情呈渐进性发展。患者首次入院后行全身激素治疗，右眼行激光虹膜周切术，第二次入院后给予全身与局部激素治疗，辅助补钾保胃及抗感染等治疗，第三次入院予以甲强龙1000 mg大剂量冲击治疗，同时予以补钾、保胃、补钙、降眼压等相关治疗。结果：眼部检查可见中度前葡萄膜炎症表现，例如虹膜后粘连、角膜后沉着、房水细胞与闪辉等现象，急性期眼底检查可见多发有团状黄白色病灶位于视网膜色素上皮与脉络毛细血管层，大小不一，数量较多，出现于视盘附近。复发炎症表现为前房与玻璃体炎症及脉络膜瘢痕外围水肿，发展到后期已经严重影响患者视力。患者考虑为多灶性脉络膜炎伴全葡萄膜炎，治疗后患者水肿部分消失，炎症吸收，视力有效改善。结论：多灶性脉络膜炎伴全葡萄膜炎有很多不同临床表现，容易误诊及漏诊，一旦发现必须及时到医院就诊，完善相关检查，降低误诊及漏诊率，应根据患者症状结合临床检查及时采取相关治疗措施，可取得较好疗效。 　　【关键词】 多灶性脉络膜炎； 全葡萄膜炎； 临床表现； 治疗 　　doi：10.14033/j.cnki.cfmr.2017.30.084 文献标识码 B 文章编号 1674-6805（2017）30-0165-03 　　Exploration of the Clinical Manifestation and Treatment of Multifocal Choroiditis with Full Uveitis/CHEN Yan-jin.//Chinese and Foreign Medical Research，2017，15（30）：165-167 　　【Abstract】 Objective：To investigate the clinical manifestation and treatment of multifocal choroidalitis with full uveitis.Method：One patient was admitted to our hospital.The patient was treated on November 28，2016.The eyes were treated with red eyes at the same time.The visual acuity decreased for 3 years. As the disease progresses the lesion into a neat border， pigment atrophic scar， as well as disc edema and congestion and so on. Patients were admitted to hospital 3 times， each condition was progressive development. Patients were hospitalized for the first time after admission， right eye line laser iris circumcision， The second admission was given after admission to the body and local hormone therapy， auxiliary potassium and stomach and anti-infection treatment， The third time received 1000 mg large doses of Ajinqiang shock treatment， at the same time received potassium， stomach， calcium， lowering intraocular pressure and other related treatment.Result：The ocular examination showed moderate anterior uveitis inflammation， such as posterior pharyngeal adhesions， posterior corneal calm， aqueous humor and o