查詢結果分析
相關文獻
- 嬰兒搖晃症候群視力預後之評估
- The Clinical Course and Visual Management of Congenital Myopia
- 視覺誘發電位對弱視兒童之診斷及視力預後之評估
- Complicated Urinary Tract Infection: Analysis of 179 Patients
- Prognostic Factors in Node-Negative Breast Cancer Patients: The Experience in Taiwan
- Reentry of a Treated Advanced Periodontal Lesion with an Acute Abscess--A Case Report
- Postoperative Radiotherapy of Adult Supratentorial High-grade Astrocytoma
- Prenatal Diagnosis and Perinatal Outcome of Facial Clefts
- Shock in the Pediatric Emergency Service: Five Years' Experience
- 糖尿病與腦中風
頁籤選單縮合
題 名 | 嬰兒搖晃症候群視力預後之評估=Prognosis of Visual Acuity in Shaken Baby Syndrome |
---|---|
作 者 | 黃瓊瑢; 林慧茹; 蔡三章; 沈戊忠; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷 期 | 38:3 1999.09[民88.09] |
頁 次 | 頁367-373 |
分類號 | 417.674 |
關鍵詞 | 嬰兒搖晃症候群; 視力; 預後; Shaken baby syndrome; Subarachnoid hemorrhage; Subdural hematoma; Visual evoked potential; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:探討搖晃嬰兒症候群的眼部變化,以及視力預後與顱內出血及眼球內出血 之關係。 方法:從1995年10月至1998年7月,對17個因搖晃嬰兒症候群住院的病例,進 行腦部影像學及眼底檢查, 來確定顱內出血及眼球內出血的型態, 並作眼底照相及 pattern-flash 視覺誘發電位( VEP )檢查,然後對病患作定期追蹤, 直到眼球內出血完 全消失,再安排視力及 VEP 檢查,有重度視障者加作腦部 CT 或 MRI 檢查。 結果:共收集17名患者年齡為2至11個月,所有患者均發生硬腦膜下血腫,其中6人( 35.3 %)併發蜘蛛網膜下出血。 此6人中有4人合併大腦水腫。眼底檢查發現有14人( 82.4 %)發生視網膜或眼球內出血,其中13人為兩眼出血。 有2人同時有視網膜內、視 網膜前及玻璃體出血;5人合併視網膜內及視網膜前出血;4人為單純視網膜內出血;2人 為單純視網膜前出血及1人是單純玻璃體出血。除3名患者在原先即無眼球內出血外,其餘 14人在追蹤2至24個月時,眼球內出血均已消失,但有1人發生兩眼黃斑部結疤。眼球 內出血消失時之視力檢查顯示有4人(此4人在發病期發生腦水腫)仍無法凝視或隨物體移 動,且 VEP 均無反應。此時加作 CT (或 MRI )顯示4人均呈兩側枕葉梗塞及廣泛性腦萎 縮。其餘13人之視力均能作凝視及隨物體移動,其中1人 VEP 正常,另12人 VEP 呈現 P 延遲。 結論:本研究顯示,眼球內出血在搖晃嬰兒症候群患者之發生率甚高,而患者視力之預後卻 與腦部受創之嚴重度較有關係。VEP 檢查則似有助於追蹤期較輕度視障的檢測,但仍須進一 步研究加以確定。 |
英文摘要 | Aim: To evaluate the ophthalmologic manifestations of shaken baby syndrome and the relationship between the prognosis of visual acuity and the severity of intracranial and intraocular hemorrhages. Methods: From October 1995 to July 1998, inpatients with shaken baby syndrome were enrolled for analysis. During the acute stage, studies including brain computed tomography (CT) or magnetic resonance imaging (MRI) , fundus examination, and pattern-flash visual evoked potential (VEP) were arranged. Reexaminations of VEP and visual acuity were performed after intraocular hemorrhages had disappeared. CT or MRI was arranged for patients with severe visual impairment in the follow-up period. Results: All patients suffered from subdural hematoma (SDH), six (35.3%) also had subarachnoid hemorrhage (SAH). Of these six cases, four associated with cerebral edema in the acute stage. Fundus examination revealed intraocular hemorrhages in 14 (82.4%) patients. Intraretinal, preretinal and vitreous hemorrhages were noted in two cases and intraretinal and preretinal hemorrhages were found in five cases. The numbers of cases with pure intraretinal. preretinal and vitreous hemorrhages were four, two and one, respectively. After a follow-up for 2 to 12 months, all patients had normal fundus examinations except one case had bilateral macular scarring. Visual acuity examination disclosed that four cases could not perform fixing and following, all of them still had no response to VEP. Reexamination of brain CT or MRI revealed bilateral occipital lobe infarction and diffuse brain atrophy in these four patients. The remaining 13 cases could perform fixing and following. However, only one had normal response to VEP, the other 12 cases had delayed P100 in VEP. Conclusions: Intraocular hemorrhages are frequently occurred in patients with shaken baby syndrome, however, the late visual acuity is mainly related to the initial brain injuries. VEP seems helpful in evaluation of the prognosis of visual acuity for patients with mild visual impairment. Further investigation and follow-up are necessary. |
本系統中英文摘要資訊取自各篇刊載內容。