Qauv Schirmer: indications, cov txheej txheem ntawm kev ua tau zoo, tau

Xeem txoj kev, uas yuav tsum tau los sib tham, yog muaj npe nyob rau hauv Honor ntawm ib tug ophthalmologist, nws yog tsim los - Otto Schirmer. Qhov no tshuaj ntsuam txiav txim rau theem ntawm kev secreted kua muag kua, cov neeg kawm ntawv ntawm av noo txij nkawm ntawm lub corneal nto.

Indications thiab contraindications

Schirmer xeem yog thov yog xav tias muaj:

• Corneal o ntawm lub conjunctiva;
• syndrome ntawm "qhuav qhov muag";
• Sjogren lub syndrome (ib tug mob, hnyav tsis connective ntaub so ntswg uas muaj feem xyuam rau cov qog uas tsim sab nraud tsis muaj kua - qaub ncaug thiab kua muag);
• mob vim slezoobrazovaniya tau txais kev kho mob npaj.

Tsim ib tug syndrome ntawm "qhuav qhov muag" tej zaum yuav ib tug xov tooj ntawm yog vim li cas:

1. Lub cev qhuav dej.
2. Cov laus neeg mob.
3. Conjunctivitis los yog lwm yam qhov muag mob.
4. Vitamin A deficiency (tsis muaj vitamin A).
5. Pos nyob rau hauv lub qhov muag.
6. Postoperative los yog tas mus li yam tab kaum tom qab laser pom kev kho.
7. Yog li ntawd-hu ua theem nrab syndrome, uas manifests nws tus kheej nyob rau hauv rheumatoid mob caj dab, leukemia, nqaij hlav.

Schirmer xeem yog ua rau:

• perforations (reshaping) ntawm lub ceev ceev;
• fistula;
• corneal rwj tsim txheej;
• scale yaig ntawm lub stratum corneum.

Txoj kev xeem

Test ib daim hlab rau cov qauv Schirmer - ib tug tshwj xeeb lim standard ntawv loj: 5 hli nyob rau hauv dav thiab 35 hli nyob rau hauv ntev. Stepping 5 hli los ntawm lub ntug sawb qhia, ophthalmologist puv nws kaum sab xis ntawm 45 degrees, thiab lowers rau ib tug tsawg dua daim tawv muag ntawm tus neeg mob, ntawm lub feem ntawm lub txheej thiab hauv nruab nrab ib feem. Nws yog ib qho tseem ceeb thaum lub sij hawm txoj kev tsis mob lub cornea.

Raws li ib co txoj kev rau tus neeg mob thaum lub sij hawm ntawm txoj kev mus kaw lub qhov muag, nyob rau lwm yam - mus saib ua ntej thiab me ntsis upward. Teeb pom kev zoo nyob rau hauv lub chav tsev yuav tsum txaus siab - tsis npub thiab tsis heev ci.

Schirmer xeem yuav siv sij hawm txog tsib feeb. Thaum lub sij hawm lub sij hawm no, daim ntawv ib daim hlab nqus cov kua muag zaj duab xis prekornealnuyu thiab dej los ntawm lub lacrimal pas dej.

Hom xeem hom kev kawm

Qauv Schirmer ua nyob rau hauv ob txoj kev:

1. Nrog rau kev siv ntawm lub zos tshuaj loog. Kev ua kom loog txwv ntxiv mus rau lub basal tso tawm reflex rhuav kua rau stimulation ntawv. Tom qab instillation ntawm lub zos ua kom loog sab fornix ntawm lub conjunctiva qhuav poob ntau heev tshuaj no yog tsis tov nrog lacrimal kua, li no ua nws cov ntim.
2. Yog tsis muaj kev siv cov kev ua kom loog agents. Xws li ib tug xeem yog tom ntej no ophthalmologists xam tau tias yog ntau yog vim hais tias nws yuav rhuav tshem cov mixing ntawm cov kua muag thiab cov tshuaj muab, qhia tau hais tias "huv" tshwm sim. Qhov no hom ntawm cov qauv yog yus nyob rau hauv diagnosing lub tsos mob "qhuav qhov muag".

Tsis tas li ntawd Schirmer xeem yog phua rau hauv kuv thiab II. Tus thawj yog nqa tawm siv lub xeem ib daim hlab los ntawm hu rau ntawm hais tias txoj kev. Qhov thib ob hom pab mus tshawb yog tus nqi ntawm cov reflex (cov tshuaj tiv thaiv rau stimuli) lacrimal kua. Nws ua zoo sib xws, tab sis nws nkoos qhov kev tso tawm ophthalmologist lacrimal secretion los ntawm stimulating qhov ntswg nqe vaj lug kub ntawm cov kev kawm nrog ib tug paj rwb kua ntswg.

Qauv Schirmer: cai thiab sib txawv

Nyob rau hauv loj heev zaum, lub syndrome ntawm "qhuav qhov muag" kev ua tau zoo hauv qhov kev xeem sawb tej zaum yuav nyob rau hauv ib theem ntawm xoom. Cov cai no yog rau cov yau tus neeg mob cov pejxeem cov nuj nqis yog tshaj 15 hli. Yog hais tias cov nqi qis rau - ces examinee suffers los ntawm ib hom "qhuav qhov muag" syndrome:

• 14-9 mm - me ntsis variation hluav qee lachrymal secretion;
• 8-4 mm - qhov nruab nrab theem ntawm kev loj hlob ntawm lub syndrome;
• tsawg tshaj li 4 mm - mob loj heev ntaub ntawv ntawm qhov syndrome corneal dryness.

Pom kev ua tau zoo: 10-30 hli. Yog hais tias tus neeg mob lub hnub nyoog tshaj 60 xyoo, tus nqi ntawm qhov kev kuaj sawb tsawg tshaj li 10 hli yuav tsum tau suav hais tias yog cai rau nws, txawm li cas los, yuav xoom nws tsis tau.

Cai rau cov qauv II, thiab txiav txim seb lub qee nqi reflex kua muag, tsis tsawg tshaj 15 hli. Tseem ceeb rau ob hom kev kuaj pom tau hais tias yuav sib txawv ntawm qhov kev kuaj tau rau ib khub ntawm ob lub qhov muag los ntawm ntau tshaj 27%.

Tom ntej mob tom qab kev ntsuam xyuas Schirmer:

• xeem txoj kab txiav teeb;
• sawv Bengal stain los yog flyuores-aub;
• Kev tshawb fawb ntawm kev nrhiav ib tug lub sij hawm luv kua muag zaj duab xis rupture.

Qauv Schirmer - yooj yim thiab ceev ceev, siv tau txoj kev rau thawj zaug mob ntawm lub syndrome ntawm "qhuav qhov muag" thiab zoo xws li cov kab zauv rau nws, cov kab mob uas cuam tshuam cov nyiaj ntawm lub lachrymal secretion. Qhov kev kuaj ntawd yuav pab kom cov ophthalmologist sai sai txiav txim rau theem ntawm kev secreted kua muag kua (basal, reflex) thiab lawv tag nrho nyob rau hauv tus neeg mob nyob rau hauv kev xeem.