工作环境相关的开放性眼外伤流行病学和临床诊疗特征

发布时间：2018-03-03 09:18

本文选题：工作环境相关的开放性眼外伤　切入点：流行病学特征　出处：《福建医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的: 探讨工作环境相关的开放性眼外伤流行病学和临床诊疗特征。方法: 1.回顾于2005年1月至2010年12月间就诊于福建医科大学附属协和医院眼科的开放性眼外伤患者136例,其中工作环境相关的开放性眼外伤58例( 59只眼),分析开放性眼外伤流行病学及临床诊疗方面的数据,包括性别、年龄、受伤后就诊时间、致伤物、就诊时视力、开放性眼外伤分类与分区、临床处理、术后视力等情况。 2.通过比较工作环境相关与非工作环境相关的开放性眼外伤有关流行病学和临床诊疗的数据,调查工作环境相关组的教育程度、工作性质、防护措施、安全培训等情况,了解工作环境相关的开放性眼外伤流行病学和临床诊疗特征。结果: 1.总共分析开放性眼外伤136例,工作环境相关组58例, 59只眼(43.1%),其中男性患者54例,占93.1%,平均年龄30岁(18- 54),非工作环境相关组中男性患者67例,占85.9%,平均年龄38.5岁(0.8-74),两者发病率在性别上有明显区别( 93.1%vs85.9%,P=0.034 ),但平均年龄无明显区别(P=0.05); 2.致伤物分为铁(铁屑,片,块等)、石块、木质物、刀具、其它金属、性质不明物。工作环境相关组致伤物中铁34例(58.6%)、石块12例(20.7%)木质物1例(1.7%)、刀具2例(3.4%)、其它金属4例( 6.9%)、性质不明物5例(8.6%);非工作环境相关组致伤物中铁20例( 25.6%)、石块15例( 19.2%)、木质物6例( 7.7%)、刀具3例(3.8%)、其它金属2例(2.6%)、性质不明物32例(41.0%); 3.按BETT系统,在工作环境相关组中,开放性眼外伤分类:钝性裂伤17例(29.3%)、穿通伤15例(25.9%)、球内异物26例(44.8%);非工作相关组中分类情况:钝性裂伤29例(37.2%)、穿通伤29例(37.2%)、球内异物20例(25.6%),两者区别明显(P =0.034)。两者在受伤后就诊时间上,无明显区别(P=0.34); 4.工作环境相关组中伤口分区同受教育程度、工作性质、安全培训、安全措施之间有负相关性。 5.工作环境相关组眼外伤临床处理情况: 57例(98.3%)一期行开放性眼外伤清创缝合术, 18例(31.0%)行晶状体切除术, 21例( 36.2%)行玻璃体切除术,8例( 13.8%)行巩膜环扎术,7例(12.1%)行抗青光眼手术,26例(53.4%)行异物取出或磁吸术,并有1例(1.7%)因严重眼内炎需要行眼内容剜除术。结论: 1.开放性眼外伤在年轻男性群体有较高的发病率; 2.工作环境相关组中,患者致伤物以铁金属制品居多,其中球内异物发生率明显增高; 3.患者最后视力敏感度与伤口分区情况密切相关。在工作环境相关组中,伤口分区情况同患者的教育程度、工作性质、防护措施、安全培训等情况有相关性; 4.强调在工作环境中认真执行安全生产制度和运用眼部安全防护措施具有重要作用; 5.正确的临床诊疗对于工作环境相关的开放性眼外伤患者的预后有重要意义。
[Abstract]:Objective:. Objective: to explore the epidemiological and clinical features of open eye trauma related to working environment. Methods:. 1. From January 2005 to December 2010, 136 patients with open ocular trauma were treated in Union Hospital of Fujian Medical University. Among them, 58 cases (59 eyes) of open eye trauma related to working environment were analyzed in epidemiology and clinical diagnosis and treatment of open eye trauma, including sex, age, time after visit to hospital, wound object, visual acuity at the time of seeing a doctor. Open ocular trauma classification and division, clinical management, postoperative visual acuity and so on. 2. By comparing the data of epidemiology and clinical diagnosis and treatment of open eye trauma related to the working environment and non-working environment, we investigated the educational level, the nature of work, the protective measures, the safety training and so on. To understand the epidemiology and clinical features of open eye trauma related to working environment. Results:. 1. A total of 136 cases of open ocular trauma, 58 cases of working environment related group and 59 eyes of 43.1 cases were analyzed. Among them, 54 cases (93.1%) were male patients, with an average age of 30 years (18 ~ 54). 67 cases were male patients in non-working environment related group. The average age was 38.5 years (0.8-74). The incidence of the disease was significantly different in sex (93.1 vs85.9), but there was no significant difference in average age (P 0.05). 2. The injured objects are divided into iron (iron chips, chips, blocks, etc.), stones, wood objects, knives, other metals, In the working environment related group, there were 34 cases of iron (58.6%), 12 cases of stones (20. 7) wood, 2 cases of cutting tools (3. 4%), 4 cases of other metals (6. 9%), 5 cases of unknown substances (8. 6%), and 20 cases of iron (25. 6%) in non-working environment related groups. There were 15 cases of stones (19.2%), 6 cases of wood (7.7%), 3 cases of cutting tools (3.8%), 2 cases of other metals (2.6%), 32 cases of unknown substances (41.0%). 3. According to the BETT system, in the work environment related group, There were 17 cases of blunt laceration, 15 cases of penetrating injury, 26 cases of intrabulbar foreign body, 26 cases of intrabulbar foreign body, 29 cases of blunt laceration, 29 cases of penetrating injury, 20 cases of intrabulbar foreign body, and 20 cases of intrabulbar foreign body, respectively, and the classification of non-working related group were as follows: 29 cases of blunt laceration, 29 cases of penetrating injury, and 20 cases of intraball foreign body, the difference was significant (P < 0. 034, P < 0. 034). At the time of seeing a doctor after the injury, There was no obvious difference between the two groups. 4. There was a negative correlation between the degree of education, nature of work, safety training and safety measures. 5. Clinical management of ocular trauma in working environment related group: 57 cases (98.3) were treated with open wound debridement and suture, 18 cases (31.0) with lens resection, 21 cases (36.2%) with vitrectomy and 7 cases with scleral ring ligation. (12. 1) A total of 26 cases (53.4%) underwent antiglaucoma surgery.) Foreign body removal or magnetic aspiration were performed. One case needed enucleation because of severe endophthalmitis. Conclusion:. 1. There is a high incidence of open eye trauma in young male population. 2. In the working environment related group, most of the injured objects were iron metal products, in which the incidence of intraball foreign bodies was significantly increased. 3. The final visual sensitivity of the patients was closely related to the wound zoning. In the working environment group, the wound zoning was correlated with the patient's education, working nature, protective measures, safety training and so on. 4. Emphasizes the importance of implementing the safety production system and the application of eye safety protection measures in the working environment; 5. Correct clinical diagnosis and treatment are important for prognosis of patients with open eye trauma related to working environment.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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