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儿童和青少年外伤性前房积血——病因与治疗

Traumatic hyphema in children and adolescents – aetiology and treatment.

作者信息

Urban Beata, Bakunowicz-Łazarczyk Alina, Michalczuk Marta

出版信息

Klin Oczna. 2016;118(2):101-4.

Abstract

PURPOSE

Retrospective analysis of patients with traumatic hyphema, including type of injury, treatment and visual outcome.

MATERIAL AND METHODS

We analysed a cohort of patients after blunt trauma, who were examined and treated between 2011– –2015. In each case, the baseline and ultimate visual acuity was determined, followed by slit lamp examination, intraocular pressure measurement, indirect binocular ophthalmoscopy of the fundus, ultrasound scan and OCT Visante. The type of treatment as well as duration of inpatient treatment and late complications were assessed for each case.

RESULTS

45 patients (45 eyes) with traumatic hyphema due to blunt ocular trauma were enrolled. 42 of them were boys (93.3%), and 3 were girls (6.7%). The age range was 2.5–17.5 years (mean age of 11.92 ± 3.75 years). Upon admission, 10 (22.2%) children had full visual acuity (1.0). The most common injuries concomitant with hyphema included iridodialysis, corneal oedema, mydriasis and corneal erosion. Secondary hemorrhage occurred three days following injury in only one (2.2%) patient. The mean duration of inpatient admission was 4.3 days (ranged from 2 to 8 days). At the last follow-up visit, 36 (80%) patients had a full visual acuity of 1.0.

CONCLUSIONS

Visual outcomes improve with earlier treatment commencement. Conservative management was sufficient to resolve traumatic hyphema in reported cases

摘要

目的

对创伤性前房积血患者进行回顾性分析,包括损伤类型、治疗方法和视力预后。

材料与方法

我们分析了一组2011年至2015年间接受检查和治疗的钝挫伤患者。在每例病例中,测定基线和最终视力,随后进行裂隙灯检查、眼压测量、眼底间接双眼检眼镜检查、超声扫描和OCT Visante检查。评估每例病例的治疗类型、住院治疗时间和晚期并发症。

结果

纳入45例(45眼)因钝性眼外伤导致创伤性前房积血的患者。其中42例为男孩(93.3%),3例为女孩(6.7%)。年龄范围为2.5至17.5岁(平均年龄11.92±3.75岁)。入院时,10例(22.2%)儿童视力正常(1.0)。与前房积血相关的最常见损伤包括虹膜根部离断、角膜水肿、瞳孔散大和角膜糜烂。仅1例(2.2%)患者在受伤后3天发生继发性出血。平均住院时间为4.3天(范围为2至8天)。在最后一次随访时,36例(80%)患者视力完全恢复至1.0。

结论

早期开始治疗可改善视力预后。在报告的病例中,保守治疗足以解决创伤性前房积血问题

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