Thomas M A, Parrish R K, Feuer W J
Arch Ophthalmol. 1986 Feb;104(2):206-10. doi: 10.1001/archopht.1986.01050140060020.
We reviewed the medical records of 175 patients who were admitted between 1977 and 1984 with a diagnosis of traumatic hyphema to define the incidence of operative intervention for the treatment of complications related to rebleeding. Of the 156 patients admitted with primary hyphemas, 25 (16%) rebled during hospitalization. Seven of these 25 in-hospital rebleeds required surgical intervention. Nineteen other patients were admitted with ocular histories and examinations strongly suggestive of rebleeding prior to admission (secondary hyphema--presumed preadmission rebleed). Seven of these 19 eyes underwent surgery. Of the 175 eyes studied, only one eye that did not rebleed underwent surgery during the initial hospitalization. Fourteen (32%) of 44 eyes that rebled underwent operative intervention. Nine of these 14 patients were operated on under general anesthesia. Potential benefits of newer hyphema treatments, such as epsilon-aminocaproic acid, designed to prevent rebleeding should be weighed against not only the ocular risks of rebleeding but also the risks of general anesthesia.
我们回顾了1977年至1984年间收治的175例诊断为外伤性前房积血患者的病历，以确定因再出血相关并发症而进行手术干预的发生率。在156例原发性前房积血患者中，25例（16%）在住院期间发生再出血。这25例住院期间再出血的患者中有7例需要手术干预。另有19例患者入院时的眼部病史和检查强烈提示入院前已发生再出血（继发性前房积血——推测入院前已发生再出血）。这19只眼中有7只接受了手术。在研究的175只眼中，只有1只未发生再出血的眼睛在首次住院期间接受了手术。44只发生再出血的眼睛中有14只（32%）接受了手术干预。这14例患者中有9例在全身麻醉下接受手术。新型前房积血治疗方法（如旨在预防再出血的ε-氨基己酸）的潜在益处，不仅应与再出血的眼部风险相权衡，还应与全身麻醉的风险相权衡。
