眼爆炸伤患者眼球损伤的临床分析

发布时间：2018-03-01 21:36

本文关键词： 眼外伤眼爆炸伤临床分析　出处：《山西医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：了解眼爆炸伤的流行病学状况,分析眼爆炸伤的发生原因及影响视力的危险因素,以期提出防治措施。方法：对山西医科大学第一、二医院眼科2005年1月-2009年12月期间住院的眼爆炸伤患者的病例资料作一回顾性研究。结果：住院患者114例(196眼),占同期眼外伤住院病例总数512例的22.3%。年龄最大者77岁,最小者5岁,平均年龄33.9±11.4岁。男性眼爆炸伤患者明显多于女性,31-40岁是眼爆炸伤高发年龄段。男性108例,占94.7%,女性6例,占5.3%,男女之比为18/1,二者有显著性差异。右眼17例,左眼15例,双眼82例(164眼)。就诊时以角膜、巩膜穿孔伤、外伤性白内障、眼内异物和视神经损伤为多。眼睑裂伤42例,角结膜异物58例,眼球内异物31例,眶内异物6例,前房出血52例,角膜裂伤45例,巩膜裂伤10例,角巩膜裂伤21例,虹膜根部离断10例,严重眼球破裂、内容物脱出38例,晶体脱位4例,外伤性白内障26例,眶骨骨折5例,合并全身其它部位损伤38例(54眼)占33.3%。治疗后27例(29眼)行眼内容物剜除术,占23.6%。双眼盲35.4%(58/164),双眼致残率43.9%(72/164)。单眼致盲率46.9%(92/196),单眼致残率41.3%(81/196)。眼爆炸伤的主要原因是雷管及炸药的爆炸。39.5%的患者由于雷管的爆炸,多是煤矿井下作业造成。其中56.1%与职业有关。其次是鞭炮(23.7%),鞭炮炸伤有明显的季节性,主要集中于每年的—二月份。其它眼爆炸伤原因包括炸药、高压锅和爆炸物不详。结论：眼爆炸伤是一种伤情严重且复杂的眼外伤,致盲及致残率较高,常合并其他器官的损伤。眼球破裂及视神经和视网膜损伤是影响视力恢复的主要因素。正确及时的手术和治疗能使部分患者保留一定的视力。山西是我国的能源基地,工矿企业较多,雷管及炸药爆炸是导致工人及青壮年眼爆炸伤的主要原因,这与经济高速发展但防范措施相对落后有关,加强劳动保护是发展中国家目前防止眼爆炸伤的首要任务。
[Abstract]:Objective: to investigate the epidemiological status of ocular explosion injury, analyze the causes of eye explosion injury and the risk factors affecting visual acuity, and propose preventive measures. Methods: a retrospective study was made on the cases of eye explosion injury in the first and second Hospital of Shanxi Medical University from January 2005 to December 2009. Results: 114 cases (196 eyes) were hospitalized, accounting for 22.3% of the 512 cases of ocular trauma in the same period. The oldest was 77 years old, the youngest was 5 years old. The mean age was 33.9 卤11.4 years. The age of ocular explosive injury in male patients was significantly higher than that in females aged 31-40 years. 108 cases of males (94.7%) were male, 6 cases of females (5.3%), the ratio of male to female was 18 / 1, there was a significant difference between them, 17 cases of right eye and 15 cases of left eye. Most of them were cornea, perforated sclera, traumatic cataract, intraocular foreign body and optic nerve injury. There were 42 cases of eyelid laceration, 58 cases of cornea conjunctiva foreign body, 31 cases of intraocular foreign body, 6 cases of intraorbital foreign body and 52 cases of anterior chamber hemorrhage. There were 45 cases of corneal laceration, 10 cases of scleral laceration, 21 cases of keroscleral laceration, 10 cases of iridotomy, 10 cases of severe ocular rupture, 38 cases of ocular rupture, 4 cases of lens dislocation, 26 cases of traumatic cataract and 5 cases of orbital fracture. 38 cases (54 eyes) complicated with injury of other parts of the body (33. 3%). After treatment, 27 cases (29 eyes) underwent enucleation of the contents of the eye. Accounting for 23.6.The binocular blindness is 35.45.58 / 164m, the binocular disability rate is 43.9. the rate of binocular blindness is 46.9. the rate of blindness is 46.90.The rate of single-eye disability is 41.31.31,81- 164.The main cause of eye explosion is detonator and explosive explosion .39.5% of the patients suffered from detonator explosion. Most of them are caused by underground operation of coal mine. 56.1% of them are related to occupation. The second is firecracker blast injury, which is obviously seasonal, mainly concentrated in February of each year. Other causes of eye explosion injury include explosives, pressure cookers and explosives unknown. Conclusion: the ocular explosion injury is a kind of serious and complicated ocular trauma with a high rate of blindness and disability. Eyeball rupture and optic nerve and retina damage are the main factors affecting the recovery of visual acuity. Correct and timely operation and treatment can make some patients retain certain visual acuity. Shanxi is the energy base of our country. There are more industrial and mining enterprises. Detonators and explosive explosions are the main causes of explosive injuries to the eyes of workers and young adults. This is related to the rapid economic development but relatively backward preventive measures. Strengthening labor protection is currently a top priority in developing countries to prevent eye explosion.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.1

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