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[纽扣电池所致角膜和结膜烧伤一例及局部损伤的实验研究结果]

[A case of button battery-induced corneal and conjunctive burn injury and experimental findings of local damage].

作者信息

Ogasawara Mikihide, Goto Satoshi, Shiba Takuya, Ohno Kenji, Shibata Tomohiro, Kouzaki Ken-ichi, Tsuneoka Hiroshi

机构信息

Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.

出版信息

Nippon Ganka Gakkai Zasshi. 2011 Aug;115(8):711-7.

Abstract

PURPOSE

To report a case of button battery-induced alkaline burn injury of the cornea and conjunctiva, with experimental findings of local damage.

CASE

A three-year-old girl had a hard and polished white opacity on the nasal lower cornea and conjunctival injection, caused by a button battery remaining in the conjunctival sac for several hours. The ocular surface was washed carefully with distilled water. The opacity improved gradually over several months and scarring was replaced by secondary pterygium.

EXPERIMENT

A button battery was placed on an eyeball of a pig, with the cathode directed toward the cornea. Corneal opacity developed in five minutes and increased thereafter. Another battery was sanded with saline-soaked gauze and the gauze near the cathode turned dark brown. This change intensified when the gauze was in contact with the side of the battery.

CONCLUSIONS

The cornea and conjunctiva of the patient were damaged by continuous exposure to alkaline solution (concentrated NaOH) after the button battery had entered the lacrimal sac causing fixation by chemosis. The recent development of smaller batteries increases the risk of similar accidents. Button battery-induced burn injuries may be severe and require immediate correct diagnosis and treatment, especially in small children who may be difficult to examine.

摘要

目的

报告一例纽扣电池所致角膜和结膜碱性烧伤病例,并阐述局部损伤的实验结果。

病例

一名三岁女孩鼻下方角膜出现坚硬且光滑的白色混浊,结膜充血,系纽扣电池留存于结膜囊数小时所致。用蒸馏水仔细冲洗眼表。混浊在数月内逐渐改善,瘢痕被继发性翼状胬肉取代。

实验

将一枚纽扣电池置于猪眼球上,阴极朝向角膜。五分钟后出现角膜混浊,此后混浊加重。另一枚电池用浸有生理盐水的纱布摩擦,靠近阴极的纱布变为深棕色。当纱布与电池侧面接触时,这种变化加剧。

结论

纽扣电池进入泪囊后,因化学性水肿固定,持续接触碱性溶液(浓氢氧化钠)导致患者角膜和结膜受损。近年来更小尺寸电池的出现增加了类似事故的风险。纽扣电池所致烧伤可能很严重,需要立即进行正确诊断和治疗,尤其是对于可能难以检查的幼儿。

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