眼睑病与泪器病精品课件

眼睑病与泪器病 菏泽医专眼科学教研室 董桂玲 眼睑病 一、睑腺炎 n定义：眼睑腺体的急性化脓性炎症 n病因：金黄色葡萄球菌感染 n分类：外睑腺炎睫毛毛囊及其周围腺体感染 内睑腺炎睑板腺感染 n临床特点：红、肿、热、痛、淋巴结肿大 n治疗：热敷、抗生素（局部全身）、切开排脓 、 n二、睑板腺囊肿 n定义：睑板腺特发的无菌性慢性肉芽肿 n临床表现：青少年，无痛结节 n鉴别诊断：内麦粒肿 睑板腺癌 n治疗：热敷、激素局部注射、抗生素点 眼、手术 三、睑缘炎 n定义：睑缘皮肤、毛囊及腺体的亚急性 或慢性炎症 n分类：鳞屑性睑缘炎 溃疡性睑缘炎 眦部睑缘炎 （一）鳞屑性睑缘炎 n病因：睑缘皮脂溢出、卵圆皮屑芽孢菌感染 n诱发因素：屈光不正、营养不良、理化刺激 n症状：痒、痛、烧灼感 n检查：红、鳞屑、分泌物、痂、睫毛脱落可再生 n治疗：去除病因、3%硼酸湿敷、抗生素眼膏 鳞屑性睑缘炎 （二）溃疡性睑缘炎 n病因：多为金葡菌引起的睫毛及腺体慢性或 亚急性化脓炎症。 n症状：严重痒、痛、烧灼感 n检查：分泌物多、小脓泡、痂、溃疡、睫毛 脱落不再生、秃睫、睑外翻 n治疗：去除病因、3%硼酸湿敷、抗生素眼膏 （三）眦部睑缘炎 n病因：Morax-Axenfeld菌, 缺乏Vit B2 n症状：痒、异物、烧灼 n检查：双侧红、糜烂 n治疗：0.2%-0.25%硫酸锌眼水、 VitB2 四、睑内翻 n定义：眼睑向眼球翻转，常合并倒睫，称为睑 内翻倒睫。 n分类：瘢痕性、老年性、婴幼儿性 n临床表现：角膜混浊、角膜新生血管、角膜溃 疡、穿孔 n治疗：根据不同病因采取不同术式 痉挛性下睑内翻 特发性下睑内翻 五、上睑下垂 n定义：各种原因造成的提上睑肌或苗勒肌功能 不全或丧失，导致上睑部分或完全下垂 n病因： 先天性 后天性:动眼神经麻痹、外伤、颈交感神经麻 痹、眼睑炎症或肿瘤、重症肌无力 n临床表现： 先天性：单眼或双眼弱视、仰头皱眉视物、合并 其他眼部先天异常。 后天性：动眼神经麻痹合并其他眼部表现 颈交感神经疾病合并同侧颜面无汗、 眼球后退，眼睑缩小。(horner综合症) 重症肌无力：早上轻晚上重；疲劳时重 双眼、全身表现。 n治疗：治疗原发病，根据病因选择治疗措施 上睑下垂 泪器病 一、慢性泪囊炎 病因： 沙眼 鼻部病变 症状：溢泪、溢脓； 泪囊积液或积脓 泪囊扩张 治疗：药物治疗 手术治疗：泪囊摘除术 鼻腔泪囊黏膜吻合术 鼻泪管阻塞泪液滞留+感染 二、急性泪囊炎 病因：泪囊及周围组织的急性化 脓性炎症 特点：泪囊区红、肿、热、痛 治疗：热敷、消炎、切开排脓、手术 新生儿泪囊炎 n病因：鼻泪管瓣膜未开放 n特点：出生后泪溢、挤压泪囊见积液或积脓 n治疗：抗生素眼水点眼并按摩 冲洗泪道 泪道探通术 JgXt0HeUr-EbSo*C8Pm%z6Nj#x3KhYu1IeVs-FcSp(D9Qn%A7Nk!x4LiYv2IfWs+GcTq)DaRn&B7Ol!y5MiZw2JgWt0GdUr)EbRo*B8Pm$z6Mj#w3KgXu1HeVr-FbSp*C9Qm%A6Nk#x4KhYv1IfVs+FcTp(DaQn&A7Ok!y5LiZv2JfWt+GdUq)EaRo&B8Ol$z5MjZw3JgXt0HeUr-EbSo*C8Pm%z6Nj#x3KhXu1IeVs-FcSp(D9Qn%A7Nk!x4LiYv2IfWs+GcTq)DaRn&B7Ol!y5MiZw2JgWt0GdUr)EbRo*B8Pm$z6Mj#w3KgXu1HeVr-FbSp*C9Qm%A6Nk#x4KhYv1IfVs+FcTp(DaQn&A7Ok!y4LiZv2JfWt+GdUq)EaRo&B8Ol$z5MjZw3JgXt0HeUr- EbSo*C8Pm%z6Nj#x3KhXu1IeVs-FcSp(C9Qn%A7Nk!x4LiYv2IfWs+GcTq)DaRn&B7Ol!y5MiZw2JgWt0GdUr)EbRo*B8Pl$z6Mj#w3KgXu1HeVr-FbSp*C9Qm%A6Nk#x4KhYv1IfVs+FcTp(DaQn&A7Ok!y4LiZv2JfWt+GdTq)EaRo&B8Ol$z5MjZw3JgXt0HeUr-EbSo*C8Pm%z6Nj#x3KhXu1IeVs-FcSp(C9Qn%A7Nk!x4LiYv2IfWs+GcTq)DaRn&B7Ol!y5MiZw2JgWt0GdUr)EbRo*B8Pl$z6Mj#w3KgXu0HeVr-FbSp*C9Qm%A6Nk#x4KhYv1IfVs+FcTp(DaQn&A7Ok!y4LiZv2JfWt+GdTq)EaRo&B8Ol$y5MjZw3JgXt0HeUr-EbSo*C8Pm%z6Nj#x3KhXu1IeVs- 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