中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
5期
432-435
,共4页
眼损伤%损伤严重度评分%性别因素%预后
眼損傷%損傷嚴重度評分%性彆因素%預後
안손상%손상엄중도평분%성별인소%예후
Eye injuries%Injury severity score%Sex factors%Prognosis
目的 总结机械性眼外伤住院患者的临床特征,并分析眼外伤评分(OTS)在患者终视力预后评估中的作用.方法 回顾性系列病例研究.对天津医科大学总医院眼科2009年1月至2010年12月住院治疗的162例(168只眼)机械性眼外伤患者的住院资料进行分析,包括患者的眼别、性别、年龄、就诊时间、致伤原因、眼外伤分类、伤眼最初视力和随诊的终视力(最佳矫正视力)等.对所有眼外伤患者进行视功能测定、裂隙灯显微镜及检眼镜的检查,还包括超声活体显微镜等辅助检查,并应用眼外伤评分对其预后进行评估.外伤类型在就诊时间,住院天数等组间比较,采用原始数据两样本比较的秩和检验；初视力与终视力以及终视力与OTS的相关性分析,采用秩相关分析；年龄、致伤原因、外伤类型及初视力与终视力等分类变量资料的统计推断,采用卡方检验；两性别发病年龄的比较,采用t检验.结果 机械性眼外伤168只眼中开放性眼外伤106只眼,闭合性眼外伤62只眼.男性患者140例(85.71％),女性患者22例(14.29％).开放性眼外伤和闭合性眼外伤患者的就诊时间中位数分别为外伤后5h及10 h,差异有统计学意义(Z=-2.547,P=0.011).机械性眼外伤高发人群为青年(≤44岁)100只眼(59.52％),其次为中年(45～59岁)46只眼(27.38％),老年(60岁及以上)22只眼(13.10％).导致眼外伤的原因以工作生产为主,共70例(41.47％),且77％(54/70)为开放性眼外伤.闭合性眼外伤的初视力及终视力均好于开放性眼外伤,差异均有统计学意义(x2=37.847,P=0.000;x2 =44.428,P=0.000).所有外伤眼终视力与初视力呈正相关(r=0.858,P=0.000).通过OTS计算后,患者的终视力与总评分(r=0.870,P=0.000)及OTS(r=0.869,P =0.000)均存在正相关.结论 本组机械性眼外伤患者男性多于女性,以开放性眼外伤为主,其就诊时间早于闭合性眼外伤,高发人群为青年,致伤原因以工作生产为主,闭合性眼外伤的初视力及终视力均好于开放性眼外伤.OTS分值可为眼外伤患者提供重要的预后信息.
目的 總結機械性眼外傷住院患者的臨床特徵,併分析眼外傷評分(OTS)在患者終視力預後評估中的作用.方法 迴顧性繫列病例研究.對天津醫科大學總醫院眼科2009年1月至2010年12月住院治療的162例(168隻眼)機械性眼外傷患者的住院資料進行分析,包括患者的眼彆、性彆、年齡、就診時間、緻傷原因、眼外傷分類、傷眼最初視力和隨診的終視力(最佳矯正視力)等.對所有眼外傷患者進行視功能測定、裂隙燈顯微鏡及檢眼鏡的檢查,還包括超聲活體顯微鏡等輔助檢查,併應用眼外傷評分對其預後進行評估.外傷類型在就診時間,住院天數等組間比較,採用原始數據兩樣本比較的秩和檢驗；初視力與終視力以及終視力與OTS的相關性分析,採用秩相關分析；年齡、緻傷原因、外傷類型及初視力與終視力等分類變量資料的統計推斷,採用卡方檢驗；兩性彆髮病年齡的比較,採用t檢驗.結果 機械性眼外傷168隻眼中開放性眼外傷106隻眼,閉閤性眼外傷62隻眼.男性患者140例(85.71％),女性患者22例(14.29％).開放性眼外傷和閉閤性眼外傷患者的就診時間中位數分彆為外傷後5h及10 h,差異有統計學意義(Z=-2.547,P=0.011).機械性眼外傷高髮人群為青年(≤44歲)100隻眼(59.52％),其次為中年(45～59歲)46隻眼(27.38％),老年(60歲及以上)22隻眼(13.10％).導緻眼外傷的原因以工作生產為主,共70例(41.47％),且77％(54/70)為開放性眼外傷.閉閤性眼外傷的初視力及終視力均好于開放性眼外傷,差異均有統計學意義(x2=37.847,P=0.000;x2 =44.428,P=0.000).所有外傷眼終視力與初視力呈正相關(r=0.858,P=0.000).通過OTS計算後,患者的終視力與總評分(r=0.870,P=0.000)及OTS(r=0.869,P =0.000)均存在正相關.結論 本組機械性眼外傷患者男性多于女性,以開放性眼外傷為主,其就診時間早于閉閤性眼外傷,高髮人群為青年,緻傷原因以工作生產為主,閉閤性眼外傷的初視力及終視力均好于開放性眼外傷.OTS分值可為眼外傷患者提供重要的預後信息.
목적 총결궤계성안외상주원환자적림상특정,병분석안외상평분(OTS)재환자종시력예후평고중적작용.방법 회고성계렬병례연구.대천진의과대학총의원안과2009년1월지2010년12월주원치료적162례(168지안)궤계성안외상환자적주원자료진행분석,포괄환자적안별、성별、년령、취진시간、치상원인、안외상분류、상안최초시력화수진적종시력(최가교정시력)등.대소유안외상환자진행시공능측정、렬극등현미경급검안경적검사,환포괄초성활체현미경등보조검사,병응용안외상평분대기예후진행평고.외상류형재취진시간,주원천수등조간비교,채용원시수거량양본비교적질화검험；초시력여종시력이급종시력여OTS적상관성분석,채용질상관분석；년령、치상원인、외상류형급초시력여종시력등분류변량자료적통계추단,채용잡방검험；량성별발병년령적비교,채용t검험.결과 궤계성안외상168지안중개방성안외상106지안,폐합성안외상62지안.남성환자140례(85.71％),녀성환자22례(14.29％).개방성안외상화폐합성안외상환자적취진시간중위수분별위외상후5h급10 h,차이유통계학의의(Z=-2.547,P=0.011).궤계성안외상고발인군위청년(≤44세)100지안(59.52％),기차위중년(45～59세)46지안(27.38％),노년(60세급이상)22지안(13.10％).도치안외상적원인이공작생산위주,공70례(41.47％),차77％(54/70)위개방성안외상.폐합성안외상적초시력급종시력균호우개방성안외상,차이균유통계학의의(x2=37.847,P=0.000;x2 =44.428,P=0.000).소유외상안종시력여초시력정정상관(r=0.858,P=0.000).통과OTS계산후,환자적종시력여총평분(r=0.870,P=0.000)급OTS(r=0.869,P =0.000)균존재정상관.결론 본조궤계성안외상환자남성다우녀성,이개방성안외상위주,기취진시간조우폐합성안외상,고발인군위청년,치상원인이공작생산위주,폐합성안외상적초시력급종시력균호우개방성안외상.OTS분치가위안외상환자제공중요적예후신식.
Objective To summarize clinical characteristics of mechanical ocular injury and to analyze the role of ocular trauma score (OTS) in the estimation of final visual acuity.Methods All cases of ocular trauma admitted to the Department of Ophthalmology from January 2009 to December 2010 were retrospectively reviewed.Data extracted included laterality of the injured eye,gender,age,presenting time,cause,ocular trauma classification,initial and final visual acuity.These injuries were classified by ocular trauma classification system (OTCS). We also used the OTS in evaluating the final visual outcome.Comparisons between groups for discontinuous variables were analyzed using rank-sum test.Rank correlation was used in analysis between initial visual acuity and final visual acuity or between final visual acuity and OTS.Chi-square test was used to analyze variables,such as age,cause,type and visual acuity.Comparison of ages between male and female was analyzed by using t-test.Results Of the 168 eyes,there were 106 open globe injury (OGI) and 62 closed globe injury (CGI).There were 140 males (85.71％) and 22 females ( 14.29％ ).Presenting time median of OGI and CGI was 5 h and 10 h respectively,and there was significant difference between these two different injuries ( Z =- 2.547,P =0.011 ).The high-risk age group was the young age group ( 100 eyes,59.52％ ),vs.the middle age group ( 46 eyes,27.38％ ) and the elder age group (22 eyes,13.10％ ).Occupation-related injury (70 eyes) was the most common cause and mainly resulted in OGI (54/70).Initial and final visual acuities in CGI were better than those of OGI (x2 =37.847,P=0.000; x2 =44.428,P =0.000).Initial visual acuity was correlated with final visual acuity ( r =0.858,P =0.000 ).Final visual acuity was significantly correlated with total score ( r =0.870,P=0.000) and OTS (r =0.869,P=0.000).Conclusions In this group of mechanical ocular trauma patients,male is more common than the female.Main type of injury is OGI and presenting time of OGI is earlier than that of CGI.The high-risk age group is the young.Main cause of injury is occupation-related injury.Initial and final visual acuities in CGI are better than those in OGI.OTS calculated at initial examination may be a useful parameter for the estimation of prognosis.
