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Jingdong book

眼科疾病诊断流程与治疗策略

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《今日临床丛书》特点:
融医学新知识、新技术、新进展于一体,适应医学教育的进步和医学教育模式转变的要求,满足中青年临床医师业务素质提高的需要;
突出实用性,指导医生解决临床上遇到的实际问题;突出新颖性,以诊断与治疗流程图展现疾病诊治的具体、可行方案;
贯彻循证医学思想,尽量采用大型随机对照临床试验、荟萃分析和系统性评价提供的证据,以充分体现现代医学模式的转变;
遵循临床思维的程序,指导青年医师运用全面的、动态的、辩证的思维方式应对不同疾病的诊治,强化临床思维能力的培养。
与本套丛书的其他分册一样,本书中我们也列出了每种疾病诊断和治疗的流程图,作为一种新的尝试。这些流程图可使整个诊疗过程清晰明了,帮助参加临床工作时间不长的医师理清思路,提高诊断的正确率,并采取适当的治疗措施。
本书内容贴近临床,书中所选疾病多为临床常见病,并结合最新的研究成果和临床需要,提供了目前认为有效或已经公认的治疗方案,以指导临床实际工作。对于部分有争议的方案也列举出来,以供参考和讨论。对于部分少见和罕见的疾病则力所能及地列出与临床相关的知识,提供有用的诊断和治疗方案,以期利于中青年医师不断提高临床诊治水平。
Content Description

《眼科疾病诊断流程与治疗策略》共分14章,结合当前最新的研究成果和临床需要,系统介绍了临床常见的各类眼科疾病的诊断与治疗策略,既提供了目前已公认的诊治方法,也列举了部分尚有争议的治疗方案;对于部分少见和罕见的疾病也力所能及地列出与临床诊治相关的知识,以指导实际工作。每章按照概述、诊断思路、治疗措施、预后评价和最新进展几个部分来叙述,均列出了诊断与治疗的流程图。最后一章包含10个临床典型病例,可供参考与讨论。
《眼科疾病诊断流程与治疗策略》适合广大眼科专业高年资住院医师、主治医师和研究生参考使用。
Catalogue

第一章 外眼疾病
第一节 睑腺炎
第二节 睑板腺囊肿
第三节 睑缘炎
第四节 病毒性睑皮炎
第五节 睑内翻
第六节 睑外翻
第七节 上睑下垂
第八节 眼睑肿瘤
第九节 急性泪腺炎
第十节 泪囊炎

第二章 角膜、结膜、巩膜疾病
第一节 结膜炎
第二节 翼状胬肉
第三节 眼表肿瘤
第四节 干眼症
第五节 感染性角膜炎
第六节 角膜基质炎
第七节 蚕蚀性角膜溃疡
第八节 Terrien边缘性角膜变性
第九节 角膜营养不良
第十节 圆锥角膜
第十一节 巩膜炎

第三章 晶体疾病
第一节 年龄相关性白内障
第二节 先天性白内障
第三节 并发性白内障
第四节 外伤性白内障
第五节 后发性白内障
第六节 晶状体脱位

第四章 青光眼
第一节 原发性闭角型青光眼
第二节 原发性开角型青光眼
第三节 高褶虹膜性青光眼
第四节 青光眼睫状体炎综合征
第五节 虹膜角膜内皮综合征
第六节 色素性青光眼
第七节 剥脱性青光眼
第八节 糖皮质激素性青光眼
第九节 晶状体性青光眼

第五章 玻璃体、视网膜疾病
第一节 飞蚊症
第二节 永存玻璃体动脉
第三节 永存原始玻璃体增生症
第四节 玻璃体积血
第五节 视网膜动脉阻塞
第六节 视网膜静脉阻塞
第七节 视网膜静脉周围炎
第八节 视网膜大动脉瘤
第九节 Coats病
第十节 Stargardt病
第十一节 中心性浆液性脉络膜视网膜病变
第十二节 特发性脉络膜新生血管
第十三节 糖尿病性视网膜病变
第四节 黄斑水肿
第五节 年龄相关性黄斑变性
第十六节 特发性息肉状脉络膜血管病变
第十七节 近视性黄斑病变
第十八节 特发性黄斑裂孔
第十九节 外伤性黄斑裂孔
第二十节 特发性黄斑前膜
第二十一节玻璃体黄斑牵拉综合征
第二十二节黄斑裂孔性视网膜脱离
第二十三节视网膜脱离
第二十四节增生性玻璃体视网膜病变
第二十五节视网膜血管样条纹
第二十六节视网膜色素变性
第二十七节视网膜母细胞瘤
第二十八节早产儿视网膜病变

第六章 葡萄膜疾病
第一节 Beheet病
第二节 虹膜睫状体炎
第三节 中间葡萄膜炎
第四节 脉络膜炎
第五节 急性视网膜坏死综合征
第六节 Fuchs异色性虹膜睫状体炎
第七节 葡萄膜肿瘤

第七章 斜视、弱视
第一节 共同性斜视
第二节 麻痹性斜视
第三节 A-V综合征
第四节 Duane眼球后退综合征
第五节 弱视

第八章 眼视光疾病
第一节 近视
第二节 远视
第三节 散光
第四节 屈光参差
第五节 老视

第九章 眼眶病
第一节 眼眶血管性病变
第二节 泪腺肿瘤
第三节 炎性假瘤
第四节 视神经肿瘤
第五节 神经纤维瘤
第六节 眼眶蜂窝织炎
第七节 甲状腺相关性免疫眼眶病

第十章 眼外伤
第一节 眼球钝挫伤
第二节 眼球穿通伤
第三节 眼化学伤
第四节 眼辐射性损伤

第十一章 神经眼科疾病
第一节 视神经炎
第二节 视盘水肿
第三节 缺血性视神经病变
第四节 视神经萎缩
第五节 视交叉病变
第六节 视路病变

第十二章 眼相关综合征
第一节 Sjogren综合征
第二节 Stevens-Johnson综合征
第三节 Sturge-weber综合征
第四节 Von-Hippel-Hndau综合征
第五节 Wyburn-Mason综合征
第六节 MarcusGunn综合征(下颌瞬目综合征)
第七节 Terson综合征
第八节 Bourneville综合征(结节性硬化症)
第九节 Usher综合征

第十三章 眼科常用技术
第一节 眼前节检查
第二节 眼底检查
第三节 眼压测量
第四节 前房角镜检查
第五节 临床视野检查
第六节 临床视觉电生理学
第七节 光学相干断层成像
第八节 海德堡视网膜视盘断层扫描
第九节 眼底荧光素血管造影
第十节 眼前段超声生物显微镜
第十一节 角膜图像分析

第十四章 病例分析
病例一 视神经炎
病例二 视盘水肿
病例三 缺血性视神经病变
病例四 视神经萎缩
病例五 视交叉病变
病例六 永存原始玻璃体增生症
病例七 特发性黄斑前膜
病例八 圆锥角膜
病例九 前部缺血性视神经病变
病例十 单纯疱疹病毒性角膜炎
图版
Book Abstract

第一章 外眼疾病
第一节 睑腺炎
一、概述
睑腺炎(hordeolum),也称麦粒肿,俗称“挑针眼”,是化脓性细菌侵入眼睑腺体而引起的一种急性炎症。致病菌多为葡萄球菌,金黄色葡萄球菌最为常见。分为外睑腺炎(exter-nal styes)和内睑腺炎(internal hordeolum)两种。外睑腺炎为睫毛毛囊根部皮脂腺(Zeis腺)或汗腺(Moll腺)急性化脓性炎症,内睑腺炎为睑板腺(Meihomian腺)急性化脓性炎症。
二、诊断思路
1.病史要点患部有红、肿、痛、热急性炎症的表现。外睑腺炎为睫毛毛囊根部皮脂腺(Zeis腺)或汗腺(Moll腺)急性化脓性炎症,在病变的早期有痛痒感,后逐渐加重,病变早期红肿弥散、胀痛、有明显压痛,并可触及硬结。病灶在外眦部者,常引起外侧球结膜水肿。数日后硬结逐渐软化,病变部位化脓,脓头在睫毛根部,脓肿破溃排脓后,红肿迅速消退,疼痛随之减退。内睑腺炎是睑板腺的急性化脓性炎症。因受睑板组织的限制红肿范围较小,疼痛较明显,睑结膜面充血明显,可见黄色脓头。脓头在睑结膜面或睑缘睑板腺开口处形成。脓肿破溃脓液可从睑板面排出到结膜囊,脓液排出后红肿消退。如致病菌毒性强或患者全身抵抗力弱,炎症可波及多腺体形成多发性脓肿,或侵犯整个睑板,引起眼睑脓肿或睑蜂窝织炎。此时眼睑红肿明显,不能睁开,触之坚硬,压痛明显并波及同侧面部,球结膜水肿剧烈,常伴有畏寒、发热、头痛等全身症状。处理不及时有可能引起败血症或海绵窦血栓形成而危及生命。
2.查体要点 主要体征为眼睑局限性红肿,炎症严重时可有上下睑红肿,皮温增高,有局限压痛,眼睑可扪及结节,早期质地较硬,有脓液形成后质地变软并可有波动感。发生在眦角者可有球结膜水肿。
轻者经治疗或未治疗而自行消退,或3~5天后硬结变软化脓,脓头在睫毛根部(外睑腺炎),睑结膜面或睑缘脸板腺开口处(内睑腺炎)形成排脓。重者常伴有同侧耳前或颌下淋巴结肿大。
3.辅助检查
(1)细菌培养和药物敏感试验:顽固反复发作者,可做脓液培养,结合药敏结果选用敏感的抗生素。全身症状严重者可行血培养。
(2)白细胞计数和分类:有全身症状者要查血象。
(3)免疫功能检查:顽固反复发作者,要排除免疫缺陷。

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