手术治疗复杂开放性眼外伤的影响因素与疗效分析  

Factors affecting surgical treatment of open complex ocular trauma and its curative effect

作　　者：邹良军 陈建勤 罗琰 

机构地区：[1]揭西县人民医院五官科,广东揭西515400 [2]河源市人民医院眼科,广东河源517000

出　　处：《华夏医学》2016年第4期88-91,共4页Acta Medicinae Sinica

摘　　要：目的：探讨玻璃体切割手术治疗复杂开放性眼外伤的临床疗效及相关影响因素。方法：回顾性分析2012年7月至2015年6月在我院接受玻璃体切割手术治疗的130例（130眼）复杂开放性眼外伤患者的临床资料,对手术成功率及影响手术疗效的因素进行分析。结果：手术治愈118例（118眼）,治愈率为90.77%,其中功能治愈87例（66.92%）,解剖治愈31例（23.84%）。术前视力〉0.02的患者其手术成功率明显高于术前视力〈0.02的患者（P〈0.05）;术前合并视网膜脱离者或者年龄〈18岁的患者其手术成功率明显降低（P〈0.05）;此外,在外伤后1~2周内接受玻璃体手术的患者其手术成功率明显高于1周以内与2周以后接受手术的者（P〈0.05）。锐器伤治愈率高于钝器伤,差异有统计学意义（P〈0.05）。结论：玻璃体切割手术治疗复杂开放性眼外伤的临床疗效确切,具有较高的治愈率,且疗效与术前的视力、年龄、是否合并视网膜脱离以及伤口类型有关。Objective： To explore the therapeutic effect of vitrectomy surgery on complex ocular trauma and ks related influencing factors. Methods： Clinical data of about 130 patients （130 eyes） with complex ocular trauma un- derwent vitrectomy in our hospital from july 2013 to June 2015 were retrospectively analyzed. The success rate of surgery and the factors influencing the curative effect were analyzed. Results： 118 cases （118 eyes） were successfully cured by surgeries, with a successful rate of 90.77%, 87 eyes （66.92%） achieved function recovery, 31 eyes （23.84%） were anatomically cured. The surgical success rate was higher in patients with visual acuity〉0.02 preoperatively than those with visual acuity 〈 0.02（P〈 0.05） ; the effects of patients without retinal detachment were significandy better than those with retinal detachment preoperatively （P 〈 0.05）. In addition, the surgical success rate in adult patients was higher than patients younger than 18 years old, and k was higher in patients undergoing post-traumatic vitrectomy surgery between 1 and 2 weeks than those after less than i week or more than 2 weeks （P 〈 0.05）; the cured rate of sharp insmanent injury was better than blunt instrument injury, which was of statisti- cal difference （P 〈0.05）. Conclusion： Most patients with severe ocular trauma underwent vitrectomy can be functionaUy cured, while some can be cured automatically. Pre-operative visual acuity, age, combined with retinal detachment and traumatic type are closely related to the prognosis.

关 键 词：玻璃体切割手术 复杂眼外伤 临床疗效 影响因素 

分 类 号：R779.1[医药卫生—眼科]