眼外伤评分法在机械性眼损伤中的法医学应用  

Application of Ocular Trauma Score in Mechanical Ocular Injury in Forensic Medicine

作　　者：项剑[1,2] 郭兆明[1,2] 王旭[1,2] 于丽丽[1,2] 刘会[1,2] 

机构地区：[1]司法文明协同创新中心,北京100088 [2]中国政法大学证据科学教育部重点实验室,北京100088

出　　处：《法医学杂志》2015年第5期352-355,共4页Journal of Forensic Medicine

基　　金："十二五"国家科技支撑计划项目(2012BAK16B03);国家自然科学基金面上项目(81172912)

摘　　要：目的探讨眼外伤评分(ocular trauma score,OTS)在机械性眼损伤视力预后评估中的应用价值。方法对411例机械性眼外伤(449眼,其中闭合性眼损伤317眼,开放性眼损伤132眼)进行OTS(以就诊初视力分级、眼球破裂伤、眼内炎、贯通伤或穿通伤、视网膜脱离、相对传入性瞳孔阻滞为评估指标),比较本组资料实际终视力比例与OTS标准终视力概率的差异,分析OTS分级与终视力之间的相关性,并对眼损伤的不同类型进行比较分析。结果实际终视力比例与OTS标准终视力概率分布相比,除OTS-3级有所差异外,其余各级均无明显差异。实际终视力与OTS分级、OTS总积分均呈线性相关(r值分别为0.71、0.73)。开放性眼损伤往往较闭合性眼损伤评分低、预后差,其中眼球破裂伤较眼球穿通伤预后更差。结论对眼外伤伤情进行OTS,可为法医学视力评估提供较为可靠的预测信息。Objective To evaluate the application value for the prognosis of mechanical ocular injury cases using ocular trauma score （OTS）. Methods Four hundred and eleven cases of mechanical ocular trauma were retrospectively reviewed. Of the 449 eyes, there were 317 closed globe injury and 132 open globe injury. OTS variables included numerical values as initial visual acuity, rupture, endophthalmitis, perforat- ing or penetrating injury, retinal detachment and relative afferent pupillary block. The differences be- tween the distribution of the final visual acuity and the probability of standard final visual acuity were compared to analyze the correlation between OTS category and final visual acuity. The different types of ocular trauma were compared. Results Compared with the distribution of final visual acuity in standard OTS score, the ratio in OTS-3 category was statistically different in present study, and no differences were found in other categories. Final visual acuity showed a great linear correlation with OTS category （r=0.71） and total score （r=0.73）. Compared with closed globe injury, open globe injury was generally associated with lower total score and poorer prognosis. Rupture injury had poorer prognosis compared with penetrating injury. Conclusion The use of OTS for the patients with ocular trauma can provide re- liable information for the evaluation of prognosis in forensic medicine.

关 键 词：法医学 眼损伤 视觉 双眼 眼外伤评分 

分 类 号：R779.12[医药卫生—眼科]