早期玻璃体切割术治疗开放性眼外伤的预后影响因素  

Factors influencing prognosis of early vitrectomy on open globe injuries

作　　者：刘珏[1] 许光军[1] 王登学 陈再洪[1] Liu Jue;Xu Guangjun;Wang Dengxue;Chen Zaihong(Department of Ophthalmology,Chongqing Emergency Medical Center)

机构地区：[1]重庆市急救医疗中心眼科,重庆400014

出　　处：《重庆医科大学学报》2020年第2期184-188,共5页Journal of Chongqing Medical University

基　　金：重庆市卫计委医学科研计划资助项目(编号:2017MSXM091)。

摘　　要：目的:探讨早期玻璃体切割术治疗开放性眼外伤影响预后的因素。方法:回顾性分析早期行玻璃体切割术治疗的25例开放性眼外伤患者临床资料,研究内容包括患者就诊视力、预后视力、眼外伤类型、眼外伤分区、晶体损伤和(或)脱位、球内异物、玻璃体积血、视网膜脱离,以及上述因素对视力预后的影响。结果:25例研究对象中,Ⅰ区损伤10只眼,占40.0%,Ⅱ区损伤8只眼,占32.0%,Ⅲ区损伤7只眼,占28.0%;就诊视力≥0.05有11只眼,占44.0%;就诊视力<0.05有14只眼,占56.0%;预后视力≥0.05有16只眼,占64.0%;预后视力<0.05有9只眼,占36.0%;就诊视力(P=0.017)、外伤分区(P=0.013)、有无玻璃体积血(P=0.033)及视网膜脱离(P=0.008)是影响预后视力的重要因素。结论:开放性眼外伤患者经早期玻璃体切割术治疗后大部分可达到功能治愈和解剖治愈,就诊视力越好的患者手术疗效相对越好,伤口位于Ⅰ区的预后视力明显优于Ⅲ区,玻璃体积血、视网膜脱离会显著影响预后视力的恢复。Objective:To investigate factors influencing prognosis of early vitrectomy on open globe injuries. Methods:Clinical data of25 patients with open globe injury who underwent early vitrectomy from July 2016 to June 2018 in our hospital were retrospectively analyzed,including visual acuity after injury,prognostic visual acuity,type of ocular trauma,division of ocular trauma,lens injury and/or dislocation,intraocular foreign body,vitreous hemorrhage,retinal detachment and influences of those factors on prognostic visual acuity. Results:Among 25 patients,10 eyes(40.0%) were injured in area Ⅰ,8 eyes(32.0%) injured in area Ⅱ and 7 eyes(28.0%)injured in area Ⅲ;11 eyes(44.0%) had visual acuity after injury≥0.05 and 14 eyes(56.0%) had visual acuity after injury<0.05;16 eyes(64.0%) had prognostic visual acuity ≥0.05 and 9 eyes(56.0%) had prognostic visual acuity <0.05. Visual acuity after injury(P=0.017),trauma zone(P=0.013),vitreous hemorrhage(P=0.033) and retinal detachment(P=0.008) were important factors influencing the prognostic visual acuity. Conclusion:After early vitrectomy,most of patients with open globe injury can achieve functional cure and anatomical cure. The better the visual acuity after injury is,the better the curative effect is. The prognostic visual acuity in areaⅠ is obviously better than that in area Ⅲ. Vitreous hemorrhage and retinal detachment can significantly influence the prognostic visual acuity.

关 键 词：开放性眼外伤 球内异物 玻璃体积血 玻璃体切割术 

分 类 号：R725.4[医药卫生—儿科]