中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
4期
469-472
,共4页
外伤%眼球破裂%手术%视力
外傷%眼毬破裂%手術%視力
외상%안구파렬%수술%시력
Trauma%Eyeball rupture%Surgery%Vision
目的 对严重的开放性眼球破裂伤,采取Ⅰ期急诊手术和治疗效果的评价,对Ⅱ期手术选择恰当的手术时机及疗效进行探讨.方法 文中34例34只眼患者,全部为单眼严重角巩膜破裂伤,均施行急诊Ⅰ期清创缝合修补术,术后予以抗炎、抗感染、对症及支持疗法,控制眼内感染,进一步完善各项检查,为Ⅱ期手术提供条件.结果 对34例34只眼患者,积极施行Ⅰ期手术治疗后,有10例10只眼视力恢复较好,未再施行Ⅱ期手术治疗；有23例23只眼施行了Ⅱ期手术治疗；另有1例1只眼多部位组织损伤较重,经Ⅰ期以及Ⅱ期手术治疗,最终有29例占全部患者的85.3％视力≥指数,最佳者达0.5～0.6.结论 发生严重的开放性眼球破裂伤后,无论伤眼有无光感,都应积极地尽快施行急诊Ⅰ期手术治疗,术后加强抗炎、抗感染、对症及支持疗法,防止并发症的发生,完善各项检查,为Ⅱ期手术积极创造条件,对挽救眼球、恢复视功能、提高不同程度视力,起着关键性的作用.
目的 對嚴重的開放性眼毬破裂傷,採取Ⅰ期急診手術和治療效果的評價,對Ⅱ期手術選擇恰噹的手術時機及療效進行探討.方法 文中34例34隻眼患者,全部為單眼嚴重角鞏膜破裂傷,均施行急診Ⅰ期清創縫閤脩補術,術後予以抗炎、抗感染、對癥及支持療法,控製眼內感染,進一步完善各項檢查,為Ⅱ期手術提供條件.結果 對34例34隻眼患者,積極施行Ⅰ期手術治療後,有10例10隻眼視力恢複較好,未再施行Ⅱ期手術治療；有23例23隻眼施行瞭Ⅱ期手術治療；另有1例1隻眼多部位組織損傷較重,經Ⅰ期以及Ⅱ期手術治療,最終有29例佔全部患者的85.3％視力≥指數,最佳者達0.5～0.6.結論 髮生嚴重的開放性眼毬破裂傷後,無論傷眼有無光感,都應積極地儘快施行急診Ⅰ期手術治療,術後加彊抗炎、抗感染、對癥及支持療法,防止併髮癥的髮生,完善各項檢查,為Ⅱ期手術積極創造條件,對輓救眼毬、恢複視功能、提高不同程度視力,起著關鍵性的作用.
목적 대엄중적개방성안구파렬상,채취Ⅰ기급진수술화치료효과적평개,대Ⅱ기수술선택흡당적수술시궤급료효진행탐토.방법 문중34례34지안환자,전부위단안엄중각공막파렬상,균시행급진Ⅰ기청창봉합수보술,술후여이항염、항감염、대증급지지요법,공제안내감염,진일보완선각항검사,위Ⅱ기수술제공조건.결과 대34례34지안환자,적겁시행Ⅰ기수술치료후,유10례10지안시력회복교호,미재시행Ⅱ기수술치료；유23례23지안시행료Ⅱ기수술치료；령유1례1지안다부위조직손상교중,경Ⅰ기이급Ⅱ기수술치료,최종유29례점전부환자적85.3％시력≥지수,최가자체0.5～0.6.결론 발생엄중적개방성안구파렬상후,무론상안유무광감,도응적겁지진쾌시행급진Ⅰ기수술치료,술후가강항염、항감염、대증급지지요법,방지병발증적발생,완선각항검사,위Ⅱ기수술적겁창조조건,대만구안구、회복시공능、제고불동정도시력,기착관건성적작용.
Objective To evaluate the treatment effect of taking stage I emergency surgery on open eye ruptures,to explore the appropriate timing of surgery and the efficacy of the Phase Ⅱ surgery choices.Methods Thirty-four cases (34 eyes),all had monocular serious corneoscleral rupture were taken the purposes of emergency I debridement repair,postoperative anti-inflammatory,anti-infective,symptomatic and supportive therapy to control intraocular infection,and further improve examinations,for providing the conditions for the phase Ⅱ surgery.Results After the actively purposes I of surgery of 34 cases (34 eyes),visual acuity of 10 cases had better recovery,not re-implementation of the Phase Ⅱ surgical treatment; 23 eyes received Phase Ⅱ surgical treatment; only one heavier case of multi-site eye injury after phase I surgery had poor visual acuity,did not undergo the stage Ⅱ surgical treatment.After surgical treatment of Ⅰ and Ⅱ,29 cases (82.35％ of all patients) with visual acuity reached 0.01-0.3,28 eyes reached 0.4-0.6,accounted for 32.35％ of all patients.Conclusions Severe open eyeball rupture,regardless of the injured eye with no light perception,should actively as soon as possible to do the purposes of emergency I of surgical treatment,postoperative strengthen anti-inflammatory,anti-infective,symptomatic and supportive therapy to prevent the occurrence of complications,to improve the inspection,and actively create conditions for the phase Ⅱ surgery to save the eye,to restore visual function,and improve the different degree of vision,plays a key role.
