儿童急性瞳孔疾病：101例患者的10年回顾性研究
Acute Pupillary Disorders in Children: A 10-Year Retrospective Study of 101 Patients.
作者信息
Garone Giacomo, Roversi Marco, Pisani Mara, La Penna Francesco, Musolino Antonio, Cristaldi Sebastian, Musolino Anna Maria, Roberto Amanda, Petrocelli Gianni, Reale Antonino, Midulla Fabio, Villani Alberto, Raucci Umberto
机构信息
Neurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, 00189 Rome, Italy.
出版信息
Children (Basel). 2023 Oct 26;10(11):1739. doi: 10.3390/children10111739.
BACKGROUND
To date, no study has specifically examined children with acute-onset pupillary motility disorders (APMD). Especially in the Emergency Department (ED), it is crucial to distinguish benign and transient conditions from life-threatening or urgent conditions (UCs). The aim of the study is to describe the clinical characteristics of children with APMD and their association with an increased risk of UCs.
METHODS
We conducted a pediatric retrospective study of APMD referred to ED over a 10-year period. We described the characteristics in the overall sample and in two subgroups divided according to urgency of the underlying condition. Furthermore, we applied a logistic regression model to identify the variables predictive of LT condition.
RESULTS
We analyzed 101 patients. In 59.4%, the APMD was isolated. In patients with extra-ocular involvement, the most frequently associated features were altered consciousness, headache, and vomiting. Exposure to toxic agents was reported in 48.5%. Urgent conditions occurred significantly more frequently in older children, presenting bilateral APMD and/or other ocular or extra-ocular manifestations.
CONCLUSIONS
Our study shows that UCs most commonly occur in patients presenting with bilateral APMD and other associated features. In unilateral/isolated APMD ophthalmological examination, exclusion of toxic exposure and observation until resolution of symptoms should be recommended.
背景
迄今为止，尚无研究专门针对急性起病的瞳孔运动障碍（APMD）患儿展开。尤其是在急诊科（ED），区分良性和短暂性病症与危及生命或紧急病症（UCs）至关重要。本研究的目的是描述APMD患儿的临床特征及其与UCs风险增加的关联。
方法
我们对10年间转诊至ED的APMD患儿进行了一项儿科回顾性研究。我们描述了总体样本以及根据潜在病症的紧急程度划分的两个亚组的特征。此外，我们应用逻辑回归模型来识别预测LT病症的变量。
结果
我们分析了101例患者。59.4%的患者APMD为孤立性。在有眼外受累的患者中，最常伴随的特征是意识改变、头痛和呕吐。48.5%的患者报告接触过有毒物质。紧急病症在年龄较大的儿童中显著更常见，表现为双侧APMD和/或其他眼部或眼外表现。
结论
我们的研究表明，UCs最常发生在出现双侧APMD和其他相关特征的患者中。对于单侧/孤立性APMD，建议进行眼科检查，排除有毒物质暴露，并观察至症状缓解。
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