目的 研究睑缘炎相关性角结膜病变(BKC)的临床特征、诊治及预后.方法 回顾分析2015年1月至2016年4月在十堰市太和医院眼科诊断为BKC并接受住院治疗的患者.结果 共有17例BKC患者纳入研究.1例为儿童BKC患者,1例为青少年,15例为成年患者;轻度BKC1例,中度BKC5例,重度BKC11例;5例为后睑缘炎型BKC,12例为全睑缘炎型BKC.经过眼睑清洁、热敷、按摩,点用抗生素滴眼液联合或不联合糖皮质激素滴眼液,同时典必殊眼膏擦睑缘,必要时联合口服抗生素治疗.经过治疗,14例BKC得到临床治愈,其中2例曾因不尊医嘱停药导致BKC复发并再次得到临床治愈;3例BKC临床好转,目前仍在治疗及随访中.经过治疗大部分BKC患者视力得到了明显改善,但少数患者由于残留角膜云翳、角膜斑翳及角膜新生血管而严重影响视力.结论BKC仍未得到临床眼科医生的足够重视,BKC临床体征较为显著,及时发现并对症治疗,预后较好;误诊及漏诊将导致患者疾病迁延不愈、角膜云翳及角膜斑翳形成等,严重影响患者的视功能.%Objective To investigate the clinical characteristics, diagnosis, treatments and prognosis of blepharo-keratoconjunctivitis ( BKC) . Methods To retrospectively analyze patients with BKC who received inpatient treatments in Department of Ophthalmology in Taihe Hospital from Jan 2015 to Apr 2016. Results There were 17 patients (15 adults, 1 teenage, 1 child) with BKC included in the study. BKC was mild ( n =1), moderate ( n =5) or severe ( n =11). In 5 cases BKC was related to posterior blepharitis and in 12 cases related to mixed blepharitis. Lid hygiene, warm compres-sion, massage, antibiotic eye drops combined with or without corticosteroids eye drops, application of tobramycin and dexa-methasone eye ointment ( T/DM) on the palpebral margin, and oral antibiotics were used if needed. 14 cases were clinical-ly cured;2 patients suffered recurrence due to not following advice;3 patients improved and were still undergoing treat-ments. Visual acuity improved noticeably in most cases and those who did not have good visual results had been complicat-ed by residual corneal nebula, corneal macula, or corneal neovascularizition. Conclusions BKC has not received enough attention by ophthalmologists. The clinical signs of BKC were obvious and its prognosis is good if treated in time and proper-ly. Misdiagnosis and missed diagnosis of BKC could result in delayed healing, formation of corneal nebula or macula, which might compromise visual function seriously.
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