玻璃体手术治疗严重眼外伤的效果及预后相关因素分析  

Effect and outcome of vitrectomy surgery in severe ocular trauma

作　　者：袁容娣[1] 刘少章[1] 纪淑兴[1] 李世宏[1] 吴明宇[1] 叶剑[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《创伤外科杂志》2010年第3期198-202,共5页Journal of Traumatic Surgery

摘　　要：目的探讨玻璃体手术治疗严重眼外伤的疗效以及影响预后的相关因素。方法回顾性分析87例严重眼外伤行玻璃体切除手术的资料。结果手术成功80眼(91.95%),其中功能治愈38眼(43.68%),失败7眼(8.05%)。28眼球内异物均成功取出。术前视力>0.01者手术成功率高于术前视力<0.01者;术前合并视网膜脱离者治疗效果明显差于无视网膜脱离者;<18岁患者手术成功率低于成人;在外伤后7～14天内接受玻璃体手术者手术成功率明显高于7天以内与14天以后手术者;闭合性眼外伤手术成功率高于开放性眼外伤;眼球破裂伤手术成功率低于穿通伤;伤口位置在Ⅲ区的眼外伤患者疗效明显差于伤口位于Ⅰ、Ⅱ区者。结论严重眼外伤经玻璃体手术治疗后大部分能解剖治愈,部分患者可功能治愈,伤眼的预后与初诊时的视力、有无视网膜脱离、手术时机、外伤类型、年龄及伤口位置有密切相关。Objective To evaluate the effect and outcome of vitrectomy surgery in cases of severe ocular trauma and analyze its prognosis-related factors.Methods Totally data of 87 cases of severe ocular trauma who underwent vitrectomy surgery were studied retrospectively.Results Successful operation was achieved in 80 eyes（91.95%）,including 38 eyes with function recovery（43.68%）,7 eyes with failed operation（8.05%）.Intraocular foreign bodies were successfully removed in 28 eyes.The success rate was higher in patients with visual acuity〉0.01 preoperatively than those with visual acuity 〈0.01.The effects of patients with retinal detachment preoperatively were significantly worse than those without retinal detachment.The success rates of surgery in patients less than 18 years of age were lower than those of adults,higher in the post-traumatic 7-14 days than those in less than 7 days or more than 14 days,higher in blunt ocular trauma than those in open ocular trauma,higher in penetrating injury than those in eyeball rupture.The efficacy of ocular trauma patients with wound locating in Ⅲ area was significantly worse than that of wound in the Ⅰ,Ⅱ area.Conclusion Most severe ocular trauma undergoing vitrectomy can be anatomically cured,and some patients can be functionally cured.Pre-operative visual acuity,combined with retinal detachment,surgical timing,age,traumatic type,and injury area are closely related to the prognosis.

关 键 词：眼外伤 玻璃体切除术 预后 

分 类 号：R779.6[医药卫生—眼科]