摘要
目的调查研究机械性眼外伤的病因、并发症及视力结果。方法收集2011年4月~2014年4月本科住院收治的机械性眼外伤477例(494眼)的临床资料,进行回顾性分析。结果机械性眼外伤发病平均年龄为(44.31±15.83)岁,男女比例为3.42∶1,右眼∶左眼为0.91∶1,大多发生在工作场所。机械性闭合性眼外伤的致伤原因主要为撞伤摔伤、拳击伤、铁棒击伤、生活物品击伤、爆炸伤等。机械性眼外伤常累及眼前后段结构(53.24%),视力损伤重(视力<0.02占44.53%)。机械性开放性眼外伤的致伤原因主要为钢丝铁丝戳伤、机械工具击伤、铁棒击伤、建筑材料击伤、撞伤摔伤等。机械性闭合性眼外伤的主要并发症包括瞳孔括约肌损伤、前房积血、视网膜震荡、外伤性虹膜睫状体炎、眼眶骨折等。机械性开放性眼外伤的主要并发症包括前房积血、眼内容物脱出、玻璃体积血、外伤性白内障、外伤性虹膜睫状体炎等。经过规范治疗视功能明显改善(闭合性眼外伤Z=-5.700,P<0.01;开放性眼外伤Z=-5.576,P<0.01)。机械性眼外伤不同损伤程度间视力预后差异有统计学意义(闭合性眼外伤χ~2=81.526,P<0.01;开放性眼外伤χ~2=33.246,P<0.01)。机械性眼外伤不同损伤分区间视力预后差异有统计学意义(闭合性眼外伤χ~2=121.063,P<0.01;开放性眼外伤χ~2=12.992,P=0.011)。结论机械性眼外伤是严重致盲性眼病,及时治疗可挽救部分视力。国际机械性眼外伤分类系统可判断视力预后。机械性眼外伤重在预防。
Objective To investigate the epidemiological and clinical characteristics, complications and visual outcomes of mechanical ocular injuries. Methods Retrospective, consecutive case series were collected. Information of 477 inpatients（494 eyes）with mechanical ocular injury in the Nantong First People＇s Hospital affiliated to Nantong University from Apr. 2011 to Apr. 2014 were analyzed. Results Average age of the patients was （44. 31 ±15.83 ）years. The ratio was 3.42：1 between male and female patients and 0.91：1 between fight and left eyes. Mechanical ocular injuries involved in both the anterior and posterior segment structures （53.24%） , and caused severe visual impairments（ visual acuity less than O. 02 accounted for 44.53% ）. Mechanical close-globe injuries were mainly caused by falls, bruises, boxing, iron bars, daily use items, explosives and so on. Mechanical open-globe injuries were mainly caused by steel wires, mechanical tools, iron bars, building materials, bruises and so on. The main complications of mechanical close-globe injuries included pupil sphincter injury, hyphema, retinal concussion, traumatic iridocyclitis, orbital fractures, etc. The main complications of mechanical open-globe injuries included hyphema, prolapse of eye contents, vitreous hemorrhage, traumatic cataract and traumatic iridocyclitis, etc. After standardized treatment, visual function was improved markedly （Z = - 5. 700, P 〈 0.01 in mechanical close-globe injuries ; Z = - 5. 576, P 〈 0.01 in mechanical open-globe injuries）. There were significant differences in the visual prognosis between different degrees of mechanical ocular injuries（x2 = 81. 526, P 〈 0.01 in mechanical close-globe injuries; Х^2 = 33. 246, P 〈 0.01 in mechanical open-globe injuries）. There were significant differences in the visual prognosis between different regions of mechanical ocular injuries（Х^2 = 121. 063, P 〈 0.01 in mechanical close-globe injuries ; Х^2 = 12. 992, P = 0. 011 in mechanical open-globe injuries�
作者
黄晓波
孙志敏
吴莹
黄黎黎
宋愈
HUANG Xiao-bo SUN Zhi-min WU Ying HUANG Li-li SONG Yu.(Department of Ophthalmology, the First People＇ s Hospital of Nantong, Nantong 226001, China)
出处
《中国眼耳鼻喉科杂志》
2017年第4期265-269,共5页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
江苏省南通市社会事业科技创新与示范项目(HS2013059)
关键词
机械性眼外伤
流行病学
分类系统
预后
防治
Mechanical ocular injury
Epidemiology
Classification system
Prognosis
Treatment and prevention
