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[眼外伤所致外伤性前房积血]

[Traumatic hyphema caused by eye injuries].

作者信息

Luksza Lucyna, Homziuk Magdalena, Nowakowska-Klimek Marta, Glasner Leopold, Iwaszkiewicz-Bilikiewicz Barbara

机构信息

Z Katedry i Kliniki Chorób Oczu Akademii Medycznej w Gdańsku.

出版信息

Klin Oczna. 2005;107(4-6):250-1.

Abstract

Hyphema is a common consequence of mechanical ocular trauma. Blood in the anterior chamber (hyphema)can occur after blunt or lacerating trauma. Traumatic hyphema is a diagnostic and therapeutic emergency. Major complications of hyphema include secondary hemorrhage, secondary glaucoma, corneal staining and disturbances in visual acuity. The aim of our study was the retrospective analysis of patients with posttraumatic hyphema. According to a prospective protocol we studied 428 patients who were examined and treated at the Emergency Department of Department of Ophthalmology Medical University of Gdansk between 1998-2004 years (ears). Data obtained included age and sex. 81% of patients were man, 19% of patients were women. Mean age of patients with ocular hyphema 6-72 years. We determined initial and final visual acuities (visual acuity - distance Snellen acuity test), intraocular pressure measurement, biomicroscopy, fundus indirect ophthalmology, gonioscopy and US- examinations (sometimes). Data obtained also were: slitlamp examinations for hyphema size, hyphema grading and corneal clarity. Most hyphemas were small, occupying less than one- third of the volume of the anterior chamber. The most common associated injuries to the eye hyphema included corneal oedema, glaucoma (secondary glaucoma), cataract and mydriasis. Traumatic hyphema is therapeutic emergency. More preventive efforts (hospitalization) were necessary, especially for children. In our study we observed 89% patients with traumatic hyphema due to non - penetrating eye injury. The assault were responsible for hyphema in 30.1% of cases and traffic accidents in 38.7% of all hyphemas. Treatment of the hyphema is generally topical. Outcome is good (in more cases), if medical treatment was quickly instituted. Surgical treatment must be reserved for a special cases, but it needs more further investigations.

摘要

前房积血是机械性眼外伤的常见后果。钝挫伤或裂伤后可发生前房积血。外伤性前房积血是一种诊断和治疗上的急症。前房积血的主要并发症包括继发性出血、继发性青光眼、角膜染色和视力障碍。我们研究的目的是对创伤性前房积血患者进行回顾性分析。根据一项前瞻性方案,我们研究了1998年至2004年期间在格但斯克医科大学眼科急诊科接受检查和治疗的428例患者。获得的数据包括年龄和性别。81%的患者为男性,19%为女性。眼外伤患者的平均年龄为6至72岁。我们测定了初始和最终视力(视力——远距离斯内伦视力测试)、眼压测量、生物显微镜检查、眼底间接检眼镜检查、前房角镜检查以及有时进行的超声检查。获得的数据还包括:裂隙灯检查前房积血大小、前房积血分级和角膜清晰度。大多数前房积血较小,占前房容积不到三分之一。与眼外伤最常见的相关损伤包括角膜水肿、青光眼(继发性青光眼)、白内障和瞳孔散大。外伤性前房积血是治疗急症。需要更多的预防措施(住院治疗),尤其是对儿童。在我们的研究中,我们观察到89%的外伤性前房积血患者是由于非穿透性眼外伤。袭击导致前房积血的病例占30.1%,交通事故导致的前房积血占所有病例的38.7%。前房积血的治疗一般采用局部治疗。如果能迅速开始药物治疗,预后通常良好(在更多病例中)。手术治疗必须保留用于特殊情况,但还需要更多进一步的研究。

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