摘要
目的分析复杂开放性眼外伤手术疗效及其相关影响因素。方法回顾性分析75例(75眼)严重眼外伤临床资料,所有患者均行Ⅰ期清创缝合术、Ⅱ期玻璃体手术,术后随访6～24个月,观察随访末期患者疗效,并对其相关影响因素进行分析,包括手术时机、外伤类型、伤口位置及年龄等。结果本组75例中,手术治愈69例,治愈率为92.00%,其中功能治愈44例(58.67%),解剖治愈25眼(33.33%)。Ⅰ期处理效果较满意患者治愈率高于Ⅰ期处理效果较差患者,差异有统计学意义(χ2=7.823,P=0.020)。伤后7～14d行玻璃体手术者治愈率明显高于伤后7d内及伤后14d后行玻璃体手术者,差异均有统计学意义(χ2=10.162、11.601,P=0.036、0.021)。锐器伤治愈率高于钝器伤,差异有统计学意义(χ2=6.341,P=0.042)。<14岁和14～50岁患者治愈率高于>50岁患者,差异均有统计学意义(χ2=11.47、10.54,P=0.022、0.031)。单纯角膜伤口患者治愈率高于后部巩膜伤口和角巩膜伤口患者,差异有统计学意义(χ2=7.909、9.194,P=0.019、0.010);其他伤口位置患者之间治愈率比较,差异均无统计学意义(χ2=3.566、4.994、0.958,均为P>0.05)。结论眼外伤患者应注意Ⅰ期显微手术的修复质量及Ⅱ期手术时机的准确把握,外伤类型、年龄及伤口位置对伤眼的手术疗效有重要影响。
Objective To evaluate the surgical effects of complicated open ocu- lar trauma and its related prognostic factors. Methods Retrospective analysis of 75 cases of severe ocular trauma was made, all patients received the first debridement sur- gery and secondary vitrectomy, the follow-up time was from 5 months to 24 months, the curative effects at the final follow-up were observed,and the related prognostic factors, including surgical time, trauma type, wounding position and age, were analyzed. Re- sults The disease was cured in 59 eyes （92.00%）, in which 44 eyes （58.57%） got functional cure ,25 eyes（ 33.33% ） got anatomical cure. The cured rate in patients satis- fied with the first surgery was higher than those dissatisfied with the first surgery, there was statistical difference （x2 = 7.823 ,P = 0.020）. The cured rate in patients received vit- rectomy from 7 days to 14 days after trauma was obviously higher than those received vitrectomy within 7 days or after 14 days,there were statistical differences（y： = 10. 162.11. 601 ,P =0.036,0.021 ）. The cured rate of sharp instrument injury was better than blunt instrument injury,there was sta- tistical difference （x2 =5.341 ,P =0.042）. The cured rate in the patients aged less than 14 years or from 14 years to 50 years were higher than those aged more than 50 years, there were statistical differences （X2 = 11.47,10.54,P = 0. 022,0.031 ）. The cured rate in the patients with only corneal wound was higher than those with posterior sclera wound or combined with cor- neal wound,there were statistical differences （x2 =7.909,9. 194,P =0. 019,0.010）,no difference was found among other wounding position （X2 = 3. 555,4.994,0.958, all P 〉 0.05 ）. Conclusion It＇ s essential to get the high quality repair in the first surgery with accurate surgery time, and the surgical effects are influenced by trauma type, age and wounding position significantly.
出处
《眼科新进展》
CAS
北大核心
2012年第12期1182-1184,共3页
Recent Advances in Ophthalmology
