开放性眼外伤216例的预后分析  

Prognostic analysis of 216 cases with penetrating ocular injury

作　　者：郭勇[1] 严宏[1] 

机构地区：[1]第四军医大学唐都医院眼科,中国陕西省西安市710038

出　　处：《国际眼科杂志》2013年第8期1729-1731,共3页International Eye Science

摘　　要：目的: 分析开放性眼外伤的相关因素,探讨影响预后的相关因素和治疗策略。方法: 回顾分析2009-11/2011-11收治的开放性眼外伤患者216例221眼。结果: 伤口超过30mm的患者13眼均发生眼球萎缩。视网膜脱出45眼中,35眼(78%)进行了玻璃体切除手术,15眼(33%)最终发生了眼球萎缩。发生脉络膜下腔出血39眼中,20眼(51%)发生了眼球萎缩。视网膜脱出和脉络膜下腔出血增加了眼球萎缩的风险(P<0.05)。巩膜裂伤96眼中,30眼(31%)Ⅰ期进行巩膜垫压+冷凝手术。112眼(51%)进行了玻璃体切除+硅油注入手术,最终64眼(29%)无光感,降低了患者失明率(P<0.05)。结论: 重度眼外伤的预后和多种因素相关,视网膜脱出和脉络膜下腔出血是判断预后的重要指征。早期的巩膜垫压+冷凝手术及玻璃体切除手术具有治疗作用,可改善患者视功能。·AIM- To analyze the factors of penetrating ocular injury, and to investigate the prognostic factors and treatment strategies. ·METHODS. A retrospective analysis of 216 ocular trauma patients （221 eyes）, in our hospital from November 2009 to November 2011, was completed. · RESULTS.. The eyeball atrophy inevitably occurred in 13 eye wounds more than 30mm. Retinal prolapse of the eyes, 78% （35/45） completed vitrectomy, 33% （15/45） were eyeball atrophy. The 51% （20/39） of subchoroidal hemorrhage eyes were eyeball atrophy. Retinal prolapse and subchoroidal hemorrhage increased the risk of ocular atrophy （P〈0.05）. Scleral rupture of the eyes, 31% （30/96） completed scleral buckling condensation surgery, 51% （112/221） completed the vitrectomy and scleral silicone oil injection surgery. Final, 29% （64/221） eyes were no light perception. It reduced the rate of blindness （P〈 0. 05）. · CONCLUSION ： Serious ocular trauma prognosis related to many factors. The retina prolapse and the subchoroidal hemorrhage were important prognosis testify. A scleral buckling condensation surgery and vitrectomy have a therapeutic effect, and can improve visual function.

关 键 词：眼外伤 玻璃体切除术 视网膜脱离 脉络膜下腔出血 眼球萎缩 

分 类 号：R779.6[医药卫生—眼科]