开放性眼球损伤伴眼眶骨折患者预后影响因素分析  

Analysis of prognostic factors in patients with open ocular injury and orbital fracture

作　　者：孙光瑞 郑晓龙 贺玲 陈伟芳 周妍妍 SUN Guang-rui;ZHENG Xiao-long;HE Ling;CHEN Wei-fang;ZHOU Yan-yan(Department of Ophthalmology and Otolaryngology,Affiliated Hospital of Xinxiang Medical College,83 Group Military Hospital of PLA,Xinxiang453700,P.R.China)

机构地区：[1]新乡医学院附属医院·中国人民解放军陆军第八十三集团军医院眼耳鼻喉科,河南新乡453700

出　　处：《社区医学杂志》2020年第19期1329-1332,共4页Journal Of Community Medicine

摘　　要：目的开放性眼球损伤伴眼眶骨折是严重的损伤性疾病,通过探讨影响开放性眼球损伤伴眼眶骨折患者预后的因素,可为临床评估和早期干预提供依据,以提高患者治疗后的生活质量。方法选择2014-01-10-2018-10-31某部医院收治的82例开放性眼外伤患者作为研究对象,收集患者的临床资料并追踪修复治疗后的最终视力情况,根据预后程度分为预后不良组和预后良好组,比较两组患者受伤后的临床特征,分析影响预后不良的相关因素。结果与预后良好组相比,预后不良组患者年龄增高(t=2.785,P=0.020),眼眶内壁骨折(χ2=7.253,P=0.007)、眼眶外壁骨折(χ2=13.884,P<0.001)、眼眶上壁骨折(χ2=7.848,P=0.005)、眼眶多部位骨折(χ2=4.643,P=0.031)和眼内异物人数增加(χ2=4.773,P=0.029),受伤至就诊时间延长(t=3.589,P<0.001),就诊时眼外伤视力评定为1级(χ2=6.165,P=0.013)和2级(χ2=30.628,P<0.001)的患者增加,4~5级(χ2=38.228,P<0.001)患者减少,差异均有统计学意义。Logistic回归结果显示,眼眶内壁骨折(OR=2.118,95%CI为1.114~4.027,P=0.022)、眼眶外壁骨折(OR=2.226,95%CI为1.101~4.501,P=0.026)、眼眶多部位骨折(OR=2.119,95%CI为1.059~4.240,P=0.034)、眼内异物(OR=1.202,95%CI为1.016~1.421,P=0.031)和受伤至就诊时间(OR=2.219,95%CI为1.095~4.497,P=0.027)是影响开放性眼球损伤伴眼眶骨折患者预后的独立危险因素,而就诊时眼外伤视力评定等级(OR=0.542,95%CI为0.346~0.849,P=0.007)是影响开放性眼球损伤伴眼眶骨折患者预后的保护因素。结论眼外伤部位、伴有眼内异物、受伤后就诊时间延长以及眼外伤视力等级低的开放性眼球损伤伴眼眶骨折患者预后较差,眼外伤后及时检查是否存在眼球损伤或异物一定程度上可以改善预后。OBJECTIVE The open eye injury orbital fracture was a serious traumatic disease.By exploring the factors affecting the prognosis of patients with open eye injury and orbital fracture,it can provide a basis for clinical evaluation and early intervention,so as to improve the quality of life of patients after treatment.METHODS Totally 82 patients with open eye trauma treated in the PLA Army 83rd Group Army Hospital from January 10,2014 to October 31,2018 were treated as the research objects.The final vision of clinical information were collected and the final vision after repair treatment was tracted.Research objects were divided into poor prognosis group and good prognosis group according to the degree of prognosis.Clinical features of two groups of patients after injury and the related factors influencing the prognosis were compared.RESULTS Compared with the good prognosis group,the patients with poor prognosis group had an increased age(t=2.785,P=0.020),and the increase in the number of fracture of the inner wall of the eye frame(χ~2=7.253,P=0.007),and fracture of the outer wall of the eye frame(χ~2=13.884,P<0.001),fractures of the upper wall of the eye frame(χ~2=7.848,P=0.005),multiple orbital fractures(χ~2=4.643,P=0.031)intraocular foreign bodies(χ~2=4.773,P=0.029).The number of patients with visual trauma visual acuity grade 1(χ~2=6.165,P=0.013)and grade 2(χ~2=30.628,P<0.001)at the time of visit increased,grade 4 to 5(χ~2=38.228,P<0.001)patients decreased,and the differences were statistically significant.Logistic regression results showed that the inner wall of the eye frame fracture(OR=2.118,95%CI:1.114-4.027,P=0.022),the outer wall of the eye frame fracture(OR=2.226,95%CI:1.101-4.501,P=0.026),orbit multi-site fractures(OR=2.119,95%CI:1.059-4.240,P=0.034),intraocular foreign body(OR=1.202,95%CI:1.016-1.421,P=0.031)and time from injury to visit(OR=2.219,95%CI:1.095-4.497,P=0.027)were independent risk factors that affect the prognosis of patients with open eye injury and orbital fractures,and the visual

关 键 词：开放性眼球损伤 眼眶骨折 预后 影响因素 

分 类 号：R779.1[医药卫生—眼科]