劳动中铁锤敲击作业致眼内金属异物伤分析  

An analysis of intraocular metallic foreign body injury during hammer percussion

作　　者：张震[1] 周佳丽[2] 王方 

机构地区：[1]南京医科大学附属上海十院临床医学院眼科,211166 [2]徐州市中心医院眼科

出　　处：《中华劳动卫生职业病杂志》2017年第12期942-943,共2页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的 探讨劳动中铁锤敲击作业致眼内金属异物伤的成因,并对异物进行结构学观察.方法 于2013年1月至2016年4月,对21例眼后段金属异物伤的住院患者进行回顾性分析,利用经巩膜外路磁吸和玻璃体切除内路异物取出两种方式手术取出异物.分析取出异物的形态,并在金相显微镜下观察其结构特性.比较眼外伤患者术前和术后出院时视力.结果 21例眼外伤患者术前平均最佳矫正视力（BCVA）为1.20±0.87,术后1周出院时BCVA为1.08±0.89,两组差异无统计学意义（t=1.516,P＞0.05）.21例眼后段金属异物均为磁性异物;15例为锤头敲击硬物（71.43％）,异物的外观形态主要为薄片的竹叶状或矛状,金相显微镜下异物为片状马氏体结构.结论 眼内金属异物伤多发于铁锤敲击,其显微结构为片状马氏体.Objective To investigate the cause of intraocular metallic foreign body injury during hammer percussion and to observe the structure of the metallic foreign bodies.Methods A retrospective analysis was performed in 21 inpatients with metallic foreign body injury in the posterior segment from January 2013 to April 2016.The foreign bodies were removed by magnetic drawing through external route of the sclera or vitrectomy.The shape of the foreign bodies was analyzed and the structural characteristics were observed under a metallurgical microscope.The visual acuity of the patients was compared before and after treatment.Results All patients were discharged at one week after surgery.There was no significant difference in mean best corrected visual acuity of the patients between before treatment and after treatment （1.20±0.87 vs.1.08±0.89,t=1.516,P〉0.05）.The metallic foreign bodies in all the 21 cases were magnetic and the injuries in 15 cases（71.43%） were caused by hammering on hard objects.The foreign bodies were mainly lamellar and shaped like a leaf or a lance.And the lamellar martensite structure was observed under a metallurgical microscope.Conclusion The intraocular metallic foreign body injury often occurs during hammer percussion and the microstructure of the foreign bodies is lamellar martensite structure.

关 键 词：眼异物 马氏体 金属 

分 类 号：R135.92[医药卫生—劳动卫生]