Gottsch J D
Wilmer Ophthalmologic Institute, Johns Hospital, Baltimore, Maryland 21205.
Retina. 1990;10 Suppl 1:S65-71. doi: 10.1097/00006982-199010001-00011.
The management of traumatic hyphema has been controversial for many years. Treatments designed to prevent secondary hemorrhage have been proposed in the literature, then later abandoned when prospective studies failed to support them. In the last several years, published studies have demonstrated the efficacy of antifibrinolytic agents in the prevention of secondary hemorrhages. These studies have left unanswered some questions, however, such as whether antifibrinolytics are as effective in children as adults, in white patients as black, and in patients with normal hemoglobin as well as those with sickle cell hemoglobinopathies. The successful treatment of patients with hyphemas hinges on identification of risk factors, proper medical management and prompt surgical intervention when medical therapy fails.
多年来，外伤性前房积血的治疗一直存在争议。文献中曾提出旨在预防继发性出血的治疗方法，但后来在前瞻性研究未能提供支持时被放弃。在过去几年中，已发表的研究证明了抗纤维蛋白溶解剂在预防继发性出血方面的有效性。然而，这些研究留下了一些未解决的问题，例如抗纤维蛋白溶解剂在儿童和成人中、在白人患者和黑人患者中、在血红蛋白正常的患者以及患有镰状细胞血红蛋白病的患者中是否同样有效。前房积血患者的成功治疗取决于危险因素的识别、适当的药物治疗以及在药物治疗失败时及时进行手术干预。
