134例眼球外伤住院军人情况分析  

The analysis of the ocular trauma in 134 hospitalized soldiers

作　　者：周美池 周润海 ZHOU Mei-chi;ZHOU Run-hai(Department of Ophthalmology,Graduate Training Base of Jinzhou Medical University,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]锦州医科大学北部战区总医院研究生培养基地眼科,辽宁沈阳110016 [2]北部战区总医院眼科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2020年第3期190-193,共4页Trauma and Critical Care Medicine

摘　　要：目的对住院军人眼球外伤类型分布情况进行统计,探讨不同类型眼球外伤致伤原因、受伤场合、就诊时间和眼球外伤预后情况。方法选取自2016年1月至2019年6月于北部战区总医院因眼球外伤住院的军人患者134例,根据眼创伤国际标准进行眼球外伤类型分类,采用眼外伤评分(OTS)对患者预后视力进行分级。统计患者致伤原因、受伤场合、就诊时间和眼球外伤预后情况。结果本组患者中,机械性眼球外伤129例(96.3%)。其中闭合性眼球外伤93例,包括钝挫伤90例,板层裂伤3例;开放性眼球外伤36例,包括破裂伤14例,角膜和(或)巩膜裂伤22例(穿通伤3例、贯通伤10例、球内异物9例)。本组患者中,非机械性眼球外伤5例(3.7%),包括化学伤3例,辐射伤2例。闭合性眼球外伤主要发生在工作训练和业余生活中,分别为46例(49.5%)、30例(32.3%);开放性眼球外伤主要发生在工作非训练中,为23例(63.9%);非机械性眼球外伤主要发生在工作非训练中,为4例(80.0%)。采用Fisher确切法对受伤类型与受伤场合进行交叉列表比较,差异有统计学意义(P<0.05)。闭合性眼球外伤主要致伤原因为四肢碰撞,共46例(49.5%);开放性眼球外伤主要致伤原因为炮弹炸伤,共20例(55.6%);非机械性眼球外伤主要致伤原因为化学物和光刺激,分别为3例(60.0%)、2例(40.0%)。采用Fisher确切法对受伤类型与致伤原因进行交叉列表比较,差异有统计学意义(P<0.05)。治疗后,患者平均视力为LogMAR(0.88±0.11),显著高于治疗前的LogMAR(0.54±0.09),差异有统计学意义(P<0.05)。闭合性眼球外伤平均就诊时间19 d,开放性眼球外伤平均就诊时间3 d,非机械性眼球外伤平均就诊时间2 d。Kruskal-Wallis检验显示,3组间平均就诊时间比较,差异有统计学意义(P<0.05)。开放性眼球外伤≤24 h就诊患者治疗后平均视力LogMAR(1.05±0.29);开放性眼球外伤>24 h就诊患者治疗后平均视力LogMAR(Objective To statistically analyze the distribution of ocular trauma types in hospitalized soldiers,to investigate the causes,injury occasions,treatment time and prognosis of different types of ocular trauma.Methods A retrospective study was performed on 134 cases of military patients with ocular trauma who were admitted from January 2016 to June 2019.According to the international standard of ocular trauma,Birmingham Eye Trauma Terminology(BETT),the types of ocular trauma were classified,and the visual acuity was graded by Ocular Trauma score(OTS).The cause of injury,the occasion of injury,the time of treatment and the prognosis of ocular trauma were counted.Results In this group,129 patients(96.3%)had mechanical ocular trauma.There were 93 cases of closed ocular trauma,including 90 cases of blunt contusion and 3 cases of lamellar laceration.There were 36 cases of open ocular trauma,including 14 cases of rupture,22 cases of corneal and/or sclera laceration(3 cases of penetrating injury,10 cases of penetrating injury and 9 cases of intraocular foreign bodies).In this group,5 patients(3.7%)had non-mechanical ocular trauma,including 3 patients with chemical injury and 2 patients with radiation injury.Closed ocular trauma mainly occurred in job training and leisure life,with 46 cases(49.5%)and 30 cases(32.3%),respectively.Open ocular trauma mainly occurred in the work of the non-training,23 cases(63.9%);non-mechanical ocular trauma mainly occurred in non-training work,with 4 cases(80.0%).Fisher′s exact method was used to compare the cross-list of injury types and injury occasions,and the difference was statistically significant(P<0.05).The main cause of closed ocular trauma was limb collision in 46 cases(49.5%).The main cause of open ocular trauma was shell injury,with a total of 20 cases(55.6%).The main causes of non-mechanical ocular trauma were chemical and photostimulation,which were 3 cases(60.0%)and 2 cases(40.0%),respectively.Fisher′s exact method was used to compare the cross-list of injury types and cau

关 键 词：军人 眼球外伤 眼外伤评分系统 预后 

分 类 号：R[医药卫生]