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目的探讨以直接检眼镜观察眼底及球结膜微循环在内科急症危象时的临床价值、方法采用直接检眼镜（不用药物散瞳）观察眼底微循环表征（标志部位“眼底黄斑区拱廊状血管网络”），以直接检眼镜 ＋ ２０Ｄ镜片观察眼球结膜及其细动、静脉血管血柱和管周表征的临床演变。列举急症危象眼部微循环障碍变化典型病例１０例（慢阻肺并肺性脑病３例、慢性肾炎并尿毒症阿—斯综合征１例、淹场１例、猝死１例、ＡＭＩ并心原性休克昏迷１例、右颞叶脑内巨大血肿并癫痫昏迷１例、高血压性脑出血、脑梗塞并脑疝各１例），并试论“表征”的临床意义。结果综合１０例急症危象眼部微循环障碍共性表征为视乳头水肿、球结膜水肿、视网膜出血、球结膜下出血、网膜动脉痉挛性阻塞、球结膜细动脉纤细、网膜静脉屈曲扩张、球结膜细静脉瘀张扭曲、视网膜色泽明暗不均一、球结膜细静脉内细胞聚集、血流呈粒摆流、粒缓流、毛细血管网络不清晰。肺性脑病呈现深蓝色“紫绀眼底”、高血压性脑出血等缺氧性脑病呈淡暗红色“紫绀眼底”。视网膜呈灰白色或甚白、屈光质混浊．提示临床脑死亡。心脏停止的瞬时呈现视乳头色淡或苍白，网膜动脉血栓如线状痕迹、网膜静脉颜色暗、静脉血柱呈现节段状。结论（１）急症危象时眼部微循环障碍具有?
Objective To investigate the clinical value of direct ophthalmoscopy in observing the microcirculation of fundus and conjunctiva in medical emergency crisis.Methods Direct ophthalmoscopy without drug mydriasis was used to observe the signs of fundus microcirculation Network “), the direct ophthalmoscope + 20D lens observation ocular conjunctiva and its fine motion, venous blood vessels and the clinical manifestations of the tubular evolution. 10 cases of acute and crisis crisis were listed as typical cases of microcirculation disturbance (3 cases of chronic obstructive pulmonary disease and pulmonary encephalopathy, 1 case of chronic nephritis and uremia and Alzheimer’s disease, 1 case of flooding, 1 case of sudden death, AMI and heart 1 case of primary shock and coma, 1 case of huge hematoma and epilepsy coma in the right temporal lobe, 1 case of hypertensive intracerebral hemorrhage, 1 case of cerebral infarction and cerebral hernia), and to discuss the clinical significance of ”characterization“. Results A total of 10 cases of acute and crisis crisis ocular microcirculation common characters were papilledema, conjunctival edema, retinal hemorrhage, subconjunctival hemorrhage, arterial spasm obstruction, subtle arteriolar stenosis, Bulbar conjunctival veins stasis distortion, retinal color light and dark uneven, conjunctival fine vein cells gathered, the blood flow was grain flow, tablets slow flow, capillary network is not clear. Pulmonary encephalopathy showed dark blue ”cyanotic fundus“, hypertensive cerebral hemorrhage and other hypoxic encephalopathy pale red ”cyanotic eye." The retina was gray or white, refractive quality of opacity. Prompt clinical brain death. Instantaneous cardiac arrest appears papular pale or pale, retinal artery thrombosis such as linear traces, retinal vein dark color, venous blood vessels showed segmental shape. Conclusions (1) Ocular microcirculation disorder in emergency crisis?