急性重度眼烧伤135例临床分析  

Clinical analysis of 135 patients with severe eyeburn

作　　者：郑莎[1] 谢汉平[1] 熊鸿燕[2] 赵增炜[3] 

机构地区：[1]第三军医大学西南医院眼科,重庆400038 [2]第三军医大学军队流行病学教研室 [3]第三军医大学卫生统计学教研室

出　　处：《中华烧伤杂志》2006年第1期50-52,共3页Chinese Journal of Burns

基　　金：国家"十五"科技攻关计划课题基金资助项目(2004BA720A15)

摘　　要：目的了解急性重度眼烧伤的临床特点、预后及并发症发生情况。方法对笔者单位病案室保存的1977-2002年住院眼烧伤患者135例(155只眼)的病历进行回顾性统计分析。分析不同深度、原因眼烧伤的眼表修复率、修复时间、致盲情况及并发症。结果治疗后Ⅲ度眼烧伤的修复时间短于Ⅳ度眼烧伤,其修复率也明显高于Ⅳ度眼烧伤(P<0．01);在不能修复的Ⅳ度眼烧伤中,酸烧伤致角膜穿孔6只眼,显著高于碱烧伤(1只眼,P<0．05)。Ⅲ度眼烧伤视力≥0．05者有 38只眼,<0．05者51只眼;Ⅳ度眼烧伤视力≥0．05者0只眼,<0．05者66只眼。78只酸、碱烧伤眼中,52只眼致盲,致盲率为66．7％;77只热烧伤眼中,65只眼致盲,致盲率为84．4％。Ⅲ度眼烧伤的并发症发生率低于Ⅳ度眼烧伤。其中Ⅲ度眼烧伤角膜穿孔、睑球粘连的发生率(1．1％、36．0％)均显著低于Ⅳ度眼烧伤(27．3％、59．1％,P<0．01)。在酸烧伤患者中,角膜穿孔及睑外翻的发生率 (29．2％、37．5％)较高。而热烧伤患者中眼睑球粘连的发生率(53．2％)较高。结论Ⅳ度眼烧伤伤后的预后差,致盲率高。目前的治疗方法尚不能完全改善其视功能及预后,有待进一步研究。Objective To investigate the clinical characteristics, prognosis, and complications of acute severe burn injury of the eyes. Methods One hundred and thirty-five patients （ 155 eyes） with acute severe burn injury of the eyes admitted to our hospital from 1977 to 2002 were analyzed retrospectively. The recovery rate and time, causes and incidence of blindness, and complications of burn injury of different depth and causes of burns were analyzed statistically. Results （ 1 ） The recovery time of patients with fullthickness burn of the eye ball was obviously shorter than that with Ⅳ degree eyeburn, and the recovery rate of those with Ⅲ degree burn was also evidently higher than that with Ⅳ degree burns（ P 〈0.01 ）. Among the patients with non-repaired IV degree eyeburn, the incidence of corneal perforation （6 eyes） in patients injured by acid was markedly higher than that by alkali （ 1 eye, P 〈 0.05 ）. There were 38 Ⅲ degree injured eyes with the visual acuity more than 0.05 and 51 with that less than 0.05. While there was no eye with the visual acuity more than 0.05 but 66 with that less than 0.05. Fifty-two out of 78 eyes injured by acid and alkali went blind with occoecatio ratio of 66.7%. But 65 out of 77 eyes injured by heat went blind with occoecatio ratio of 84.4%. The complication in patients with Ⅲ degree eyeburn was lower than that with IV degree burns, The incidence of corneal perforation and symblepharon in patients with Ⅲ degree eyeburn was 1. 1% and 36.0% , which was obviously lower than that with Ⅳ degree eyeburn （27.3% and 59, 1% , P 〈0.01 ）. The highest incidence of corneal perforation and symblepharon was in those with eyeburn injured by acid （29.2% , 37.5% ）. While the highest incidence of the symblepharon in those with thermal eyeburn was 53.2%. Conclusion Among the patients with IV degree burns, those with acid, alkali and heat burns have bad prognosis, with high blindness rate. Current therapies cant improve eye function and prognosis of

关 键 词：眼烧伤 眼表修复 并发症 

分 类 号：R779.1[医药卫生—眼科] R135.14[医药卫生—临床医学]