玻璃体切除联合巩膜扣带术治疗开放性眼外伤效果的因素研究  

Influencing factors of effect of vitrectomy combined with scleral buckling for patients with open eyeball injury

作　　者：董有慧 张成霞[1] 郁美霞 徐凯[1] Dong Youhui;Zhang Chengxia;Yu Meixia;Xu Kai(Department of Ophthalmology,Lianyungang First People's Hospital,Lianyungang 222002,China)

机构地区：[1]连云港市第一人民医院眼科,连云港222002

出　　处：《国际医药卫生导报》2024年第23期3956-3961,共6页International Medicine and Health Guidance News

基　　金：江苏医药职业学院校外教学基地科研发展专项课题(20229146)。

摘　　要：目的分析玻璃体切除联合巩膜扣带术治疗开放性眼外伤效果的影响因素。方法选取连云港市第一人民医院眼科2020年1月至2023年7月收治的167例开放性眼外伤患者进行前瞻性研究。其中,男129例,女38例,年龄25~59(42.04±8.10)岁。所有患者均行玻璃体切除联合巩膜扣带术治疗,根据治疗效果将其分为治疗有效组和治疗无效组。统计学方法采用χ^(2)检验、t检验,采用多因素logistic回归分析玻璃体切除联合巩膜扣带术治疗开放性眼外伤效果的影响因素。结果167例开放性眼外伤患者中106例治疗有效[63.47%(106/167)],纳入治疗有效组,61例治疗无效[36.53%(61/167)],纳入治疗无效组。治疗无效组术前最佳矫正视力(BCVA)<0.1、损伤区域Ⅲ区、损伤类型眼内异物、合并眼内炎占比均高于治疗有效组[68.85%(42/61)比49.06%(52/106)、26.23%(16/61)比12.26%(13/106)、52.46%(32/61)比33.02%(35/106)、54.10%(33/61)比33.96%(36/106)],手术时机7~14 d占比低于治疗有效组[77.05%(47/61)比91.51%(97/106)],伤口长度长于治疗有效组[(4.21±0.42)mm比(3.96±0.36)mm],差异均有统计学意义(χ^(2)=6.17、6.92、7.02、6.48、6.83,t=4.06;均P<0.05)。多因素logistic回归分析显示,术前BCVA<0.1[比值比(OR)=2.174,95%置信区间(CI)1.012~4.672]、伤口长度(OR=5.224,95%CI 1.936~14.100)、损伤区域Ⅲ区(OR=4.064,95%CI 1.517~10.884)、损伤类型眼内异物(OR=3.236,95%CI 1.425~7.350)、合并眼内炎(OR=2.879,95%CI 1.346~6.161)均是玻璃体切除联合巩膜扣带术治疗开放性眼外伤效果的危险因素,手术时机7~14 d(OR=0.225,95%CI0.064~0.788)是其保护因素(均P<0.05)。结论术前BCVA、伤口长度、损伤区域、损伤类型、合并眼内炎、手术时机均是玻璃体切除联合巩膜扣带术治疗开放性眼外伤效果的影响因素。Objective To analyze the influencing factors of the effect of vitrectomy combined with scleral buckling in the treatment of patients with open eyeball injury.Methods A total of 167 patients with open eyeball injury treated at Department of Ophthalmology,Lianyungang First People's Hospital from January 2020 to July 2023 were selected as the study objects,including 176 males and 38 females.They were 25-59(42.04±8.10)years old.All the patients underwent vitrectomy and scleral buckling surgery,and were divided into an effective treatment group and an ineffective treatment group based on the treatment effect.χ^(2) test and t test were used for the statistical analysis.Multivariate logistic regression was used to analyze the influencing factors of vitrectomy combined with scleral buckling in the treatment of the patients with open eyeball injury.Results Among the 167 patients,106 were effectively treated,with an effective rate of 63.47%(106/167).They were included in the treatment effective group.The rest 61 patients were ineffective,with an ineffective rate of 36.53%(61/167).They were included in the treatment ineffective group.The proportion of preoperative best corrected visual acuity(BCVA)<0.1,the proportion of injury zone Ⅲ,the proportion of injury type of intraocular foreign bodies,and the incidence rate of endophthalmitis in the treatment ineffective group were higher than those in the effective treatment group[68.85%(42/61)vs.49.06%(52/106),26.23%(16/61)vs.12.26%(13/106),52.46%(32/61)vs.33.02%(35/106),and 54.10%(33/61)vs.33.96%(36/106)];the proportion of surgery timing between 7-14 d in the treatment ineffective group was lower than that in the treatment effective group[77.05%(47/61)vs.91.51%(97/106)];the length of the wound in the treatment ineffective group was longer than that in the treatment effective group[(4.21±0.42)mm vs.(3.96±0.36)mm];there were statistical differences(χ^(2)=6.17,6.92,7.02,6.48,and 6.83;t=4.06;all P<0.05).The multivariate logistic regression analysis showed that preoperative BCV

关 键 词：玻璃体切除术 巩膜扣带术 开放性眼外伤 影响因素 

分 类 号：R779.1[医药卫生—眼科]