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腹腔穿刺术作为外伤性前房积血的手术干预:尼日利亚眼科医生的观点与实践

Paracentesis as surgical intervention in traumatic hyphaema: opinions and practices of nigerian ophthalmologists.

作者信息

Chuka Okosa Michael, Obizoba Onyekwe Lawrence

机构信息

Department of Ophthalmology, Nnamdi Azikiwe University Teaching Hospital, Guinness Eye Centre Onitsha, Nigeria. College of Health Sciences Nnamdi Azikiwe University, Nnewi campus, Nigeria.

出版信息

Ophthalmol Eye Dis. 2012 Aug 30;4:71-8. doi: 10.4137/OED.S9411. Print 2012.

Abstract

INTRODUCTION

Various aspects of management of traumatic hyphaema are enmeshed in controversy. Surgery is done to prevent complications: optic atrophy and corneal blood staining occurring if a high risk exists of either or both occurring. Circumstances considered high risk do not enjoy universal consensus.

OBJECTIVES

To determine what Nigerian ophthalmologists consider absolute indications for surgical intervention by means of anterior chamber paracentesis and hyphaema washout in closed globe traumatic hyphaema, evaluate these absolute indications, and attempt to evolve a guideline for surgical intervention based on areas of consensus and disagreement.

METHOD

A semi-structured, pre-tested questionnaire with responses analyzed with SPSS 11 software.

RESULT

Near universal agreement on indication exist on early corneal blood staining and sickle cell haemoglobinopathy. Differing views concern blackball, volume and duration of hyphaema and secondary hypertension-associated hyphaema. However, it appears surgery is embarked on earlier than other practitioners elsewhere may consider necessary.

CONCLUSION

Risk level for non-surgical management against risk and benefit of surgery should be evaluated for each individual before surgery.

摘要

引言

外伤性前房积血的管理在各个方面都存在争议。进行手术是为了预防并发症:如果存在发生视神经萎缩和角膜血染其中之一或两者的高风险,就要进行手术。被认为是高风险的情况并未得到普遍认同。

目的

确定尼日利亚眼科医生对于闭合性眼球外伤所致前房积血进行前房穿刺和前房积血冲洗手术干预的绝对指征,评估这些绝对指征,并试图根据共识和分歧领域制定手术干预指南。

方法

采用经过预测试的半结构化问卷,并使用SPSS 11软件对回答进行分析。

结果

对于早期角膜血染和镰状细胞血红蛋白病的指征几乎达成了普遍共识。对于前房积血的颜色、量和持续时间以及继发性高血压相关性前房积血存在不同观点。然而,手术开始的时间似乎比其他地方的从业者认为必要的时间更早。

结论

术前应针对每个个体评估非手术治疗的风险水平与手术的风险和益处。

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Contemporary aspects in the prognosis of traumatic hyphemas.外伤性前房积血预后的当代研究进展
Clin Ophthalmol. 2009;3:287-90. doi: 10.2147/opth.s5399. Epub 2009 Jun 2.
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Surv Ophthalmol. 2002 Jul-Aug;47(4):297-334. doi: 10.1016/s0039-6257(02)00317-x.
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Traumatic hyphema: outcomes of outpatient management.外伤性前房积血:门诊治疗的结果
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