中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
4期
345-349
,共5页
眼外伤预测%穿通性眼外伤%外伤性白内障%儿童%视力预后
眼外傷預測%穿通性眼外傷%外傷性白內障%兒童%視力預後
안외상예측%천통성안외상%외상성백내장%인동%시력예후
Ocular trauma prediction%Penetrating eye injuries%Traumatic cataract%Pediatric%Visual outcome
目的 探讨眼外伤OTS (ocular trauma score)、CART (classification and regression tree)及POTS (penetrating ocular trauma score)预测模型对儿童穿通性眼外伤性白内障患者视力预后的预测价值.方法 临床病例系列研究.对2007年1月至2012年12月在浙江大学医学院附属第一医院眼科就诊的80例穿通性外伤性白内障的资料进行回顾性分析.将OTS、CART及POTS预测模型的预测结果与真实视力比较,评估各自的预测价值.结果 与预后相关的临床变量有:相对传导性瞳孔阻滞、伤口等级、伤后初始视力、视网膜脱离、眼内炎、眼睑裂伤、前房积血、玻璃体积血和无人工晶状体植入等.对视力≥光感的预测灵敏度:OTS模型为77.1％,CART模型为92.9％.对视力≥0.05的预测灵敏度:OTS模型为56.7％,CART模型为98.3％.对视力无光感的预测特异度:OTS和CART模型均为100％.对视力＜0.05的预测特异度:OTS模型为100％,CART模型为66.7％.根据POTS模型,获得评分较高者与视力预后≥0.05者关联性高,差异有统计学意义(P =0.000).结论 OTS和CART模型在预测儿童穿通性眼外伤性白内障患者视力预后时有较高的预测价值.当患儿伤后初始视力无法获得或相对传导性瞳孔阻滞无法确定时,POTS模型有一定的预测价值.
目的 探討眼外傷OTS (ocular trauma score)、CART (classification and regression tree)及POTS (penetrating ocular trauma score)預測模型對兒童穿通性眼外傷性白內障患者視力預後的預測價值.方法 臨床病例繫列研究.對2007年1月至2012年12月在浙江大學醫學院附屬第一醫院眼科就診的80例穿通性外傷性白內障的資料進行迴顧性分析.將OTS、CART及POTS預測模型的預測結果與真實視力比較,評估各自的預測價值.結果 與預後相關的臨床變量有:相對傳導性瞳孔阻滯、傷口等級、傷後初始視力、視網膜脫離、眼內炎、眼瞼裂傷、前房積血、玻璃體積血和無人工晶狀體植入等.對視力≥光感的預測靈敏度:OTS模型為77.1％,CART模型為92.9％.對視力≥0.05的預測靈敏度:OTS模型為56.7％,CART模型為98.3％.對視力無光感的預測特異度:OTS和CART模型均為100％.對視力＜0.05的預測特異度:OTS模型為100％,CART模型為66.7％.根據POTS模型,穫得評分較高者與視力預後≥0.05者關聯性高,差異有統計學意義(P =0.000).結論 OTS和CART模型在預測兒童穿通性眼外傷性白內障患者視力預後時有較高的預測價值.噹患兒傷後初始視力無法穫得或相對傳導性瞳孔阻滯無法確定時,POTS模型有一定的預測價值.
목적 탐토안외상OTS (ocular trauma score)、CART (classification and regression tree)급POTS (penetrating ocular trauma score)예측모형대인동천통성안외상성백내장환자시력예후적예측개치.방법 림상병례계렬연구.대2007년1월지2012년12월재절강대학의학원부속제일의원안과취진적80례천통성외상성백내장적자료진행회고성분석.장OTS、CART급POTS예측모형적예측결과여진실시력비교,평고각자적예측개치.결과 여예후상관적림상변량유:상대전도성동공조체、상구등급、상후초시시력、시망막탈리、안내염、안검렬상、전방적혈、파리체적혈화무인공정상체식입등.대시력≥광감적예측령민도:OTS모형위77.1％,CART모형위92.9％.대시력≥0.05적예측령민도:OTS모형위56.7％,CART모형위98.3％.대시력무광감적예측특이도:OTS화CART모형균위100％.대시력＜0.05적예측특이도:OTS모형위100％,CART모형위66.7％.근거POTS모형,획득평분교고자여시력예후≥0.05자관련성고,차이유통계학의의(P =0.000).결론 OTS화CART모형재예측인동천통성안외상성백내장환자시력예후시유교고적예측개치.당환인상후초시시력무법획득혹상대전도성동공조체무법학정시,POTS모형유일정적예측개치.
Objective To discuss the ocular trauma score (OTS),the classification and regression tree (CART) and the penetrating ocular trauma score (POTS) as prognostic models for visual outcome in pediatric traumatic cataract cases after penetrating eye injuries.Methods Eighty pediatric traumatic cataract cases after penetrating trauma were retrospectively reviewed.The OTS,CART and POTS predictions with the actual visual outcomes were compared to assess the predictive value of the models.Results The variables associated with visual outcome were a relative afferent papillary defect (RAPD),location,poor initial vision,retinal detachment,endophthalmitis,lid laceration,hyphema,vitreous haemorrhage and no intraocular lens implantation.The sensitivity to predict visual LP or better was 77.1％ for OTS and 92.9％ for CART.The sensitivity to predict 3/60 or better was 56.7％ for OTS and 98.3％ for CART.The specificity to predict no vision was 100％ for both.The specificity to predict worse than 3/ 60 was 100％ for OTS and 66.7％ for CART.According to the POTS,higher POTS was related to better prognosis (P =0.000).Conclusions Both the OTS and CART have high predictive value for pediatric traumatic cataract cases after penetrating eye injuries.Given the limitation of missing data in calculating OTS and CART,the POTS has certain predictive value.
