Txoj kev sim hauv nqe lus nug yog muaj npe tom qab tus kws kho qhov muag uas tsim nws, Otto Schirmer. Qhov kev ntsuam xyuas no txiav txim siab txog qib ntawm cov kua muag zais cia, qib ntawm cov dej noo ntawm lub qhov muag ntawm lub qhov muag.
Indications thiab contraindications
Schirmer's test yog siv thaum muaj qhov xav tias:
- mob pob txha ntawm pob txha;
- qhov muag qhuav;
- Sjögren's Syndrome (qhov mob hnyav zuj zus ntawm cov ntaub so ntswg uas cuam tshuam rau cov qog uas tso tawm sab nraud - salivary thiab lacrimal);
- kua muag poob vim yog tshuaj.
Qhov muag qhuav tuaj yeem tsim muaj ntau yam:
- Dehydration.
- Tus neeg laus laus.
- Conjunctivitis lossis lwm yam kab mob qhov muag.
- Hypovitaminosis A (tsis muaj vitamin A hauv lub cev).
- qhov muag dawb.
- Postoperative los yog tas mus li teeb meem tom qab laser pom kev kho.
- Lub npe hu ua Secondary Syndrome, uas tshwm sim nws tus kheej hauv mob caj dab rheumatoid, leukemia, lymphoma.
Schirmer test yog contraindicated nyob rau hauv:
- perforation (zoo li hloov)pob muag;
- fistula;
- txhim kho rwj ntawm pob txha pob txha;
- loj-teev yaig ntawm stratum corneum.
Test method
Schirmer xeem strips yog cov ntawv lim tshwj xeeb ntawm tus qauv loj: 5 hli dav thiab 35 hli ntev. Stepping rov qab 5 hli los ntawm cov cim ntug ntawm daim kab xev, tus kws kho qhov muag tig nws lub kaum sab xis ntawm 45 degrees thiab txo qis nws qab tus neeg mob daim tawv muag, tsom rau thaj tsam ntawm sab nrauv thiab nruab nrab. Nws yog ib qho tseem ceeb tsis txhob kov lub cornea thaum tus txheej txheem.
Raws li qee txoj hauv kev, tus neeg mob yuav tsum kaw nws lub qhov muag thaum lub sijhawm txheej txheem, raws li lwm tus - saib ua ntej thiab nce me ntsis. Lub teeb pom kev hauv chaw ua haujlwm yuav tsum xis nyob - tsis dim thiab tsis ci dhau.
Qhov kev xeem Schirmer kav li tsib feeb. Thaum lub sij hawm no, daim ntawv strips nqus cov precorneal kua muag zaj duab xis thiab noo noo los ntawm lub kua muag pas dej.
hom kev xeem cov txheej txheem
Schirmer's test yog ua nyob rau hauv ob txoj kev:
- Siv tshuaj loog hauv zos. Cov tshuaj loog tshem tawm qhov sib ntxiv ntawm reflex tear secretion rau cov kua dej basal teb rau daim ntawv khaus. Tom qab instillation ntawm cov tshuaj loog, lub qis fornix ntawm lub conjunctiva yog drained kom ntau tee ntawm cov tshuaj tsis sib tov nrog cov kua lacrimal, yog li ua rau nws ntim.
- Tsis siv tshuaj loog. Qhov kev sim no suav nrog ntau tus kws kho qhov muag kom pom tseeb dua, vim tias nws tshem tawm tag nrho cov kua muag thiab cov tshuaj tswj hwm, thiab tsuas yog qhia tau tias "huv" nkaus xwb. Hom kev xeem no yog ib yam raukuaj pom cov tsos mob ntawm "qhov muag qhuav".
Tsis tas li, qhov kev xeem Schirmer tau muab faib ua I thiab II. Thawj yog ua los ntawm kev siv cov strips kuaj raws li tus qauv qhia los ntawm peb. Hom thib ob pab tshawb xyuas cov txiaj ntsig ntawm reflex (kev cuam tshuam rau kev irritant) lacrimal secretions. Nws yog ua raws li txoj kev zoo sib xws, tab sis tib lub sijhawm, tus kws kho mob ophthalmologist txhawb kev tso tawm ntawm lacrimal secretion los ntawm kev khaus ntawm qhov ntswg ntawm qhov tshuaj ntsuam nrog paj rwb swab.
Schirmer's test: Norm and deviations
Hauv qhov mob hnyav ntawm qhov muag qhuav, qhov kev nyeem ntawm daim kab xev ntsuas yuav nyob ntawm qib xoom. Cov qauv rau cov tub ntxhais hluas txuas ntxiv ntawm cov neeg mob yog qhov ntsuas siab tshaj 15 hli. Yog tias qhov ntsuas qis dua, ces tus neeg kawm raug kev txom nyem los ntawm ib yam ntawm "qhov muag qhuav" syndrome:
- 14-9 hli - me ntsis txawv ntawm inhibition ntawm kua muag secretion;
- 8-4 hli - qhov nruab nrab ntawm kev loj hlob ntawm tus mob;
- tsawg dua 4 hli - cov ntaub ntawv hnyav ntawm pob txha qhuav qhuav.
Kev ua tau zoo tshaj plaws: 10-30 mm. Yog tias tus neeg mob muaj hnub nyoog tshaj 60 xyoo, tom qab ntawd ib qho kev xeem ntawv nyeem qis dua 10 hli yuav suav tias yog ib txwm muaj rau nws, tab sis nws yuav tsum tsis txhob nyiam xoom.
Cov qauv rau cov qauv II, uas txiav txim siab tus nqi ntawm reflex kua muag tso tawm, tsis tsawg dua 15 hli. Qhov sib txawv ntawm qhov kev xeem rau ob lub qhov muag los ntawm ntau dua 27% yog suav tias yog qhov tseem ceeb rau ob hom qauv.
Kev soj ntsuam tom qab tom qab kev sim Schirmer:
- slit lamp exam;
- coloured nrog liab bengal lossis fluores-dog;
- tshawb nrhiav kom pom lub sijhawm luv ntawm kua muag zaj duab xis tawg.
Schirmer's test yog ib txoj hauv kev yooj yim thiab ceev, zoo rau kev kuaj pom thawj zaug ntawm qhov muag qhuav thiab cov tsos mob zoo sib xws, cov kab mob uas cuam tshuam rau kev tso tawm lacrimal secretions. Qhov kev sim no pab tus kws kho qhov muag kom txiav txim siab sai sai ntawm cov kua muag kua muag (basal, reflex) thiab lawv cov ntsuas tag nrho hauv tus neeg mob kuaj.
