手术治疗儿童外伤性眼内炎的临床疗效与影响因素  

Clinical research of surgery on traumatic endophthalmitis in children

作　　者：唐晶[1] 钟捷[2] 黄海[1] 万宇[1] 樊宗山[1] 

机构地区：[1]南充市中心医院眼科.川北医学院第二临床医学院,四川南充637000 [2]四川省医学科学院.四川省人民医院,四川成都610072

出　　处：《西部医学》2017年第12期1727-1730,共4页Medical Journal of West China

摘　　要：目的探讨手术治疗儿童外伤性眼内炎的临床疗效与影响因素和预后。方法纳入南充市中心医院2011年10月至2015年3月接诊的儿童眼内炎行玻璃体切割手术患儿55例(55眼),根据手术方式不同分为3组,Ⅰ组(玻切+硅油填充)16只眼,Ⅱ组(玻切+硅油填充+注药)21只眼,Ⅲ组(环扎+玻切+硅油填充+注药)18只眼。术后随访≥6个月,评估最佳矫正视力、视网膜复位情况。结果儿童眼内炎行玻璃体切割术后视网膜脱离的总发生率为21.8%,Ⅰ、Ⅱ、Ⅲ组发生率分别为43.8%,19.0%,5.6%,经卡方检验,三组间差异有统计学意义(P<0.05)。7天内行手术者36例,7天后行手术者19例,术后视网膜脱离发生率有统计学意义(P<0.05)。所有病例炎症均得到控制。结论儿童眼内炎由于其特殊性,玻璃体切割联合巩膜外环扎、曲安奈德玻璃体腔注射、硅油填充可有效预防术后视网膜再脱离,尽早手术有利于提高手术预后效果。Objective To investigate the clinical effect after vitrectomy of traumatic endophthalmitis in children, and analyze its factors and prognosis. Methods We retrospectively analyzed the clinical data of 55 cases （55 eyes） with a clinical diagnosis of endophthalmitis received vitrectomy from Oct 2011 to March 2015. The patients were divided into three groups according to the operation manners. All the patients were followed-up longer than 6 months. The BRVA and retinal reposition were observed. Results The general rate of retinal detachment after vitrectomy was 21.8%. In the three different manners of vitrectomy, the rates of retinal detachment were 43.8%, 19.0% and 5.6%. The data was processed with Chi-square test and the differences between the three groups were statistically significant（P〈0.05）. 36 cases received surgery within 7 days after injury and 19 cases more than 7 days after injury. The rate of retinal redetach- ment was statistically different（P=0. 012）. The infection in all cases were controlled. Conclusion As for the clinical features of endophthalmitis in children, vitrectomy combined with scleral encircling, triamcinolone intravitreous injection and silicone oil tamponade was effective in prevention of retinal redetachment and should he managed as soon as possible.

关 键 词：儿童 外伤性眼内炎 玻璃体切割术 玻璃体腔药物注射 

分 类 号：R779.1[医药卫生—眼科]