眼内异物患者治疗效果影响因素分析  

Analysis of factors affecting the therapeutic efficacy on intraocular foreign bodies

作　　者：苑悦悦 万文萃[1] 彭洁 王倩[1] 闫磐石[1] Yuan Yueyue;Wan Wencui;Peng Jie;Wang Qian;Yan Panshi(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincical Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科、河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2023年第2期81-86,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：孝感市自然科学计划项目(XGKJ2021010033)。

摘　　要：目的分析眼内异物患者治疗效果的影响因素。方法回顾性病例系列研究。收集郑州大学第一附属医院2019年1月至2020年12月132例(132只眼)眼内异物的临床资料。根据异物位置、性质等因素采用不同的手术方式进行治疗, 所有患者入院后立即静脉应用抗生素, 眼内炎患者均给予玻璃体内注射万古霉素。术后随访6个月~1年。对眼内异物患者治疗效果影响因素进行分析。结果年龄2~84(44.53±13.99)岁。男124例, 女8例。异物性质以金属为主。最终视力(BCVA, logMAR)为0.91±0.48显著优于术前的1.87±0.62 (t=8.36, P<0.001), 其中7例无光感, 12例光感/手动, 7例0.005~0.095, 62例0.1~0.4, 44例≥0.5。最终视力与术前视力正相关(r=0.53, P<0.001)。低等级眼外伤评分(P<0.001)、眼后段异物(P=0.002)、4 d后异物摘出(P=0.036)、一期修复(P=0.035)及眼内炎(P=0.003)患者最终视力较差。术前视力较佳(OR=1.78, 95%CI:1.17~2.69, P=0.007)及4 d内异物摘出(OR=3.17, 95%CI:1.12~8.94, P=0.029)是最终视力的保护因素。结论眼内异物患者治疗效果与术前视力、眼外伤评分、异物位置、异物摘出时间、一期修复及眼内炎等因素有相关性。Objective To analyze factors affecting the therapeutic efficacy for patients with intraocular foreign bodies(IOFBs).Methods This was a retrospective case series study.The clinical data of 132 eyes of 132 cases of intraocular foreign bodies from Jan.2019 to Dec.2020 in the First Affiliated Hospital of Zhengzhou University were analyzed.Based on the location,nature and other factors of the foreign bodies,different surgical methods were applied.All patients received intravenous antibiotics immediately after admission and patients with endophthalmitis received intravitreal injection of vancomycin.The follow-up time was from 6 months to 1 year.The visual acuity,complications and other factors were observed.The factors influencing the therapeutic efficacy for patients with IOFBs were analyzed.Results The age of patients ranged from 2 to 84 years,with an average of(44.53±13.99)years.There were 124 males and 8 females.The type of IOFBs was mainly metal.The final visual acuity(BCVA,logMAR)was 0.91±0.48,which was better than the preoperative visual acuity of 1.87±0.62(t=8.36,P<0.001).The final visual acuity were no light perception in 7 cases,light perception or hand movement in 12 cases,from 0.005 to 0.095 in 7 cases,from 0.1 to 0.4 in 62 cases and≥0.5 in 44 cases.There was positive correlation between the final BCVA and the preoperative BCVA(r=0.53,P<0.001).Patients with low-grade ocular trauma score(P<0.001),posterior IOFBs(P=0.002),IOFBs removal after 4 days(P=0.036),primary repair(P=0.035)and endophthalmitis(P=0.003)had poorer final visual acuity.Better preoperative BCVA(OR=1.78,95%CI:1.17-2.69,P=0.007)and extracting IOFBs within 4 days(OR=3.17,95%CI:1.12-8.94,P=0.029)were protective factors for the final BCVA.Conclusion The therapeutic efficacy on IOFBs are related to the following factors:preoperative BCVA,the ocular trauma score,the location of foreign bodies,the time of extracting IOFBs,the primary repair,and the endophthalmitis.

关 键 词：损伤 眼 穿透性 眼异物 效果 治疗 因素 影响 

分 类 号：R779.14[医药卫生—眼科]