双边局部麻醉药滥用角质病变 (keratopathy)
Supriya Sharma1, Vaibhav Nagpal1, Prajakta Dandekar1
1Cornea and Anterior Segment, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India.
BMJ case reports
|May 16, 2025
概括
经常使用局部麻醉剂普拉巴卡因化,可导致严重的眼损伤,模仿传染性角膜炎. 患者通常不披露其使用情况,导致诊断延迟和视力丧失.
科学领域:
- 眼科医生 眼科 眼科
- 毒理学 毒理学 毒理学
背景情况:
- 局部麻醉剂,如普拉巴卡因化,用于缓解疼痛.
- 长时间使用可能导致眼睛表面毒性.
- 错误诊断传染性角膜炎是一种风险.
研究的目的:
- 为了强调频繁使用局部麻醉剂的危险性.
- 为了区分麻醉引起的角质炎和传染性原因.
- 为了强调一个彻底的病史的重要性.
主要方法:
- 一个患者的病例报告,患有严重的双侧眼痛和视力损害.
- 审查患者的治疗史,包括未披露的局部麻醉剂使用.
- 临床检查显示角膜上皮缺陷和树皮.
- 用羊水膜移植和tarsorrhaphy进行治疗,然后进行穿透式角质整形.
主要成果:
- 经常使用普拉巴卡因化会导致双边近乎完全的角膜上皮缺陷.
- 胚胎膜移植和tarsorrhaphy促进了上皮质的愈合.
- 角质炎症逐渐减少.
- 视力恢复是通过穿透式角质整形实现的.
结论:
- 经常使用局部麻醉剂可能会导致严重的视力威胁的角膜并发症.
- 麻醉引起的角质炎可以模仿传染性角质炎,延迟适当的治疗.
- 获得完整的病史,包括未披露的药物使用,对于准确的诊断和管理至关重要.
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