眼内异物的B超诊断及漏诊分析(1)
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【摘要】 目的 分析眼内异物的B超诊断图像特征及漏诊情况。方法 应用Cine-Scan法国光太AB超声诊断仪对我院126例手术前眼内异物外伤患者进行B超检查,并根据经手术后情况进行分析。结果 金属异物占74.6%,非金属异物占25.4% ;球内异物占81.8%、眼球壁异物占9.5%和眶内异物占7.1%;漏诊占1.6%。漏诊原因主要是B超未能发现微小异物和临床医生未对有眼内异物征象的外伤患者行B超检查。结论 B超检查对眼内异物具有较高的临床诊断价值。在眼科临床诊疗过程中,对有眼外伤史尤其有眼内异物症状的患者,B超应列为常规检查,以避免漏诊、误诊。
【关键词】 眼内异物; B超;分析;漏诊
Diagnostic Value of B-type Ultrasound for intraocular foreign bodies and missed diagnosis in 126 inpatient cases
LIN Xian-xuan,LUO Rong-jiang,PENG Ling-mei,et al.
Department of Ophthalmology,The First Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510080,China
【Abstract】 Objective To evaluate the roles of diagnosing intraocular foreign bodies (IOFB) and missed diagnosis with B-type ultrasound.Methods Retrospective study of 126 clinic inpatient cases. Results The rate of metallic foreign body(MFB) was 74.6%,the rate of intraocular foreign body was 81.8%,the rate of intraorbital foreign body was 7.1%;The missed diagnosis rate of B-type ultrasound for intraocular foreign bodies was 1.6%,the discovering rates were decreased for anterior segment and retrobulbar intraocular foreign bodies,and the showing rate was high to the vitreous opacity and retinal detachment caused by intraocular foreign bodies. Conclusion Type ultrasound can provide the required information on diagnosis and surgery design of IOFB. Small intraocular metal foreign bodies are easily misdiagnosed and missed diagnosed. Routine examination including B-type ultrasound for patients who had symptoms of intraocular foreign bodies,can obviously reduce the misdiagnosis and missed diagnosis.
【Key words】 Intraocular foreign bodies(IOFB); B-type ultrasound;Analysis;Missed diagnosis
眼内异物是一种病情及后果严重的外伤性眼病。眼内异物即可对眼球造成机械性,化学性损伤,又可因异物不及时取出,导致眼内感染甚至失明等严重后果。因此,早期正确诊断眼内异物的意义重大。本文对术前126例眼内异物患者行B超检查,结果分析如下。
1 资料与方法
1.1 临床资料 2000年1月至2009年10月本院以眼内异物住院的眼外伤患者126例,住院治疗前均行眼B超检查。126例患者中,右眼72例,左眼47例,双眼同时发现异物7例。男103例,女23例。年龄5~66岁,平均31岁。均有不同程度的眼外伤史,病程1 h~8 d不等。
1.2 仪器与方法 所有患者均由专人使用Cine-Scan法国光太AB超声诊断仪作B超检查,B超探头频率为10 MHZ ,患者采用仰卧位,轻闭双眼,上睑皮肤涂超声耦合剂,探头置于眼睑皮肤。进行多方位扫查,常规观察眼球内回声情况,注意有无异常回声及异物的特征表现,必要时嘱患者移动眼球,以了解病变的运动及后运动情况,并可调节增益同时观察病变的B超回声强度和A超波峰的变化情况。
2 结果
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