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Steven Bentman 丁香诊所 马里兰大学医学院附属医院

马里兰大学医学院附属医院视频 / 时长16分钟

丁香诊所全科培训课程 49:常见结膜炎的诊治与用药

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课程介绍

在丁香诊所「全科医生强化培训班」中,马里兰大学医学院附属医院医生委员会主席 Steve Bentman 与大家一起讨论《常见结膜炎的诊治与用药》。

病毒性结膜炎最常见的病原体是腺病毒,其次还有单纯疱疹病毒和水痘-带状疱疹病毒。一般累及双眼,后两种病毒可表现为单眼累及。

腺病毒性结膜炎极具传染性,为接触传播。表现为结膜充血,球结膜水肿和眼睑水肿,可有轻度刺痛,可伴流感症状。视力检查一般无视力损伤,下睑结膜可见滤泡。是自限性疾病,治疗包括冷敷,勤洗手,萘甲唑林滴眼药收缩血管,人工泪液,不需要抗生素,严禁使用激素。病程为 2~3 周。

单纯疱疹性结膜炎,表现为畏光,视力模糊,流泪,结膜充血,剧痛,滤泡性结膜炎,眼睑可有水疱,荧光素染色可发现角膜树突。可有皮损或眼睑周围可见水疱(Hutchinson 征)。治疗可用如 1% 曲氟尿苷滴眼液 2 小时 1 次,痊愈后改为 4 小时 1 次维持 7 天,5% 阿糖腺苷眼膏 1 天 5 次,口服抗病毒药可选用阿昔洛韦 600~800 mg,一天 5 次,7~10 天,有合并细菌感染的风险,应建议立即转诊至眼科。

水痘-带状疱疹病毒引起的结膜炎,常伴水痘或水疱征,疼痛,感觉异常,荧光素染色可见角膜树突,严重时角膜上可见水疱和溃疡,可导致失明。当患者鼻尖有病变时,需怀疑本病的可能。治疗主要是抗病毒,如阿昔洛韦 600~800 mg,一天 5 次,7~10 天,并立即转诊至眼科。

眼科疾患需重视视力检查,激素使用必须由眼科专科医师决定,全科医生应牢记不能予以眼科疾患激素。

 

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Steven Bentman 丁香诊所 马里兰大学医学院附属医院

Steven Bentman,马里兰大学医学院附属医院医生委员会主席。

M.D, University of Maryland Upper Chesapeake Medical Center 500 Upper Chesapeake Drive Belair Maryland

Experience:
June 1998-Present
Emergency Medicine Physician
Medical Director of the Department of Emergency Medicine,(July 2007--Present) Maryland Emergency Medicine Network, University of Maryland.
President of the Medical Staff, (January 2010-January 2014)
Board Member University of Maryland Upper Chesapeake Medical Center (Januaryl/10-1/2014)
Vice President of the Medical Staff, (January2009-- December 2010) Upper Chesapeake Medical Center
Interim Chairman of the Department of Emergency Medicine (December 2006--July2007)
Interim Chairman of the Department of Emergency Medicine (July 2004 -- January 2005)
Member of the Medical Executive Committee(August 2004 -- February 2006), (December2006--Present)
Member of the Performance Improvement Committee(August 2004 -- February 2006), (December 2006--Present)
Member of the STEMI Committee (July 2008 -- Present)
Member of the Stroke Committee (July 2008 -- Present)
Member of the Ethics Committee (July 1998 -- July 2007)
Best Physicians in Baltimore Maryland 2010
Doctor Awards 2005 Best Bedside Manner, Best Communicator
Physician of the Quarter 2001 recognized for service excellence

June 1992-June 1998
Emergency Medicine Physician:
Capital Emergency Associates/EM Care Doctors Hospital
8118 Good luck Road
Lanham, MD 20706

Associate Partner Capital Emergey Associates Education Sel'Vices Coordinator/EMS
Physician Member of the Fast-track Committee Implementation
Physician Member of the Emergey Medicine Department Renovation Committee
Member of Capital Emergency Associates and EM Care Leadership Team
Instructor Nursing Internship Program
Preceptor for the Anne Arundel Hospital Physician Assistant Program
Preceptor for the Essex Community College Physician Assistant Program
Chairman of the Emergency Department Task Force Committee

July 1988- June 1992
Internist
Internal Medicine Physician
White Marsh Medical Center 8817 Bel Air Road
Baltimore MD 21236

July 1985 -- June 1988
Resident Internal Medicine (July 1985- June 1987)
Harrisburg Hospital
South Front Street
Harrisburg PA 17101

Chief Medical Resident (July 1987-- June 1988)
Member of the Special Care Committee (July 1987 -- June 1988)
Member of the Trauma Team

July 1984 - June 1985
Intern Internal Medicine (Julyl984-Junel985)
Lincoln Hospital
234 East 149, Street
Bronx New York

Education
June 1984
Medical Doctor, Universidad Autonoma de Ciudad Juarez Ciudad Juarez, Chihuahua Mexico
June 1979
Bachelor of Science, Long Island University, C. W. Post,Greendale New York
June 1974, High School Diploma, Division Avenue High School, Division Avenue, Levittown New York 11756

Certifications
Board of Internal Medicine, ABIM 1992
Board of Emergency Medicine, BECM 1992
Advanced Cardiac Life-support
Advanced Trauma Life-support
Advanced Pediatric Life-support

Professional Organizaions
Amencan College of Emergency Physicians
Physician Leadershlp Academy Member (Aug. 2003-Present)

Professional Licenses
Pennsylvania
Maryland
Virginia

Hospital Affiliations
University of Maryland Upper Chesapeake Medical Center, 500 Upper Chesapeake Drive, Bel Air, Maryland 21014
University of Maryland Harford Memorial Hospital, 501 South Union Avenue,
Havre de Grace Maryland 21078
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