石河子地区儿童眼外伤的致伤原因和致盲因素分析
|
摘要
目的:研究儿童眼外伤致伤原因及致盲分析,提出防治措施。方法:收集163例眼外伤患者(14岁以下)的年龄、性别、致伤物、眼别、眼外伤分类、并发症,并比较治疗前后的视力,采用OTS评分比较与预后视力是否相关。结果:眼外伤男女比为3.79∶1;学龄儿童7～10岁最多见;就诊时间≤24h内最多见。性质主要为闭合性眼外伤;受伤原因主要为跌倒撞击伤;类型主要是钝挫伤;受伤环境多发于居民区及附近;最常见并发症为前房积血、外伤性白内障。将入院视力按≥0.05分组,其中就诊时间、外伤性质、并发症、受伤类别、手术有差异,并发症为独立影响因素[OR=2.708,95%CI(1.285～5.705)];将治疗后视力是否提高分组,其中性别、年龄、就诊时间、外伤性质、并发症有差异,性别、年龄、就诊时间为独立影响因素,就诊时间的OR值为2.895,95%CI(1.296～6.465)。结论:眼外伤是儿童主要致盲性眼病之一,但预防可以降低绝大多数眼外伤的发生。
AIM: To study the causes of ocular trauma and howit leads to blindness in children and to put forward preventive measures.METHODS: Collect related data of 163 cases of ocular trauma(under 14 years old), including age, sex, vulnerant(causes of ocular trauma), ophthalmology, classification of ocular trauma and complications. And make a comparison of the visual acuity before and after treatment. OTS score is used to make an analysis of the correlation between the prognosis and the visual acuity.RESULTS: The ratio of male to female is 3.79∶1; the most common group lies on the school-age children(7-10 years old); the visit time is ≤24 h. Closed ocular trauma is the most common one. Collision injury is the main cause with blunt trauma as major type. Most patients got injured in residential areas and nearby areas. The most common complications are anterior chamber hemorrhage and traumatic cataract. The visual acuity of admission is grouped based on whether it is ≥0.05 or not. There are differences in visit time, nature of trauma, complications,trauma type and surgery, among which complications are independent influencing factors [OR=2.708, 95%CI(1.285-5.705)]. After the treatment, the visual acuity is grouped based on whether it is improved or not. There are differences in gender, age, visit time, nature of trauma and complications among which gender, age and visit time are independent influencing factors. The OR value of visit time is 2.895, 95%CI(1.296-6.465).CONCLUSION: Ocular trauma is one of the main causes leading to blindness in children. However, it is possible to reduce the occurrence of most ocular trauma by preventive measures.
AIM: To study the causes of ocular trauma and howit leads to blindness in children and to put forward preventive measures.METHODS: Collect related data of 163 cases of ocular trauma(under 14 years old), including age, sex, vulnerant(causes of ocular trauma), ophthalmology, classification of ocular trauma and complications. And make a comparison of the visual acuity before and after treatment. OTS score is used to make an analysis of the correlation between the prognosis and the visual acuity.RESULTS: The ratio of male to female is 3.79∶1; the most common group lies on the school-age children(7-10 years old); the visit time is ≤24 h. Closed ocular trauma is the most common one. Collision injury is the main cause with blunt trauma as major type. Most patients got injured in residential areas and nearby areas. The most common complications are anterior chamber hemorrhage and traumatic cataract. The visual acuity of admission is grouped based on whether it is ≥0.05 or not. There are differences in visit time, nature of trauma, complications,trauma type and surgery, among which complications are independent influencing factors [OR=2.708, 95%CI(1.285-5.705)]. After the treatment, the visual acuity is grouped based on whether it is improved or not. There are differences in gender, age, visit time, nature of trauma and complications among which gender, age and visit time are independent influencing factors. The OR value of visit time is 2.895, 95%CI(1.296-6.465).CONCLUSION: Ocular trauma is one of the main causes leading to blindness in children. However, it is possible to reduce the occurrence of most ocular trauma by preventive measures.
引文
1 Gyawali R,Bhayal BK,Adhikary R, et al. Retrospective data on causes of childhood vision impairment in Eritrea. BMC Ophthalmol 2017;17(1):209
2北京协和医院世界卫生组织疾病分类合作中心. ICD-10疾病和有关健康问题国际统计分类. 北京:人民卫生出版社1996:351-373
3 Pieramici DJ,Jr SP, Sr AT,et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol 1998; 125(4):565-566
4 Kuhn F,Maisiak R, Mann L, et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002;15:163-165
5李晓苹,钟梅. 河南省济源市农村儿童眼外伤原因分析. 中华眼外伤职业眼病杂志2015;37(3):215-218
6 Archambault C,Gabias C,Fallaha N,et al. Pediatric ocular injuries: a 3-year review of patients presenting to an emergency department in Canada. Can J Ophthalmol 2018:S0008418217313327
7 Liu ML,Chang YS,Tseng SH, et al. Major pediatric ocular trauma in Taiwan. J Pediatric Ophthalmol Strabismus 2010;47(2):88
8刘金花,陈红,张颖,等. 402例儿童眼外伤临床因素分析. 解放军医学院学报2016;37(6):556-559
9 Serrano JC,Chalela P,Arias JD. Epidemiology of Childhood Ocular Trauma in a Northeastern Colombian Region. Arch Ophthalmol 2003;121(10):1439-1445
10张曼姝. 儿童眼外伤的致伤因素与特征分析. 郑州大学2014
11梁春. 儿童眼外伤282例临床分析. 中国民族民间医药2010;19(24):145
12 Bunting H,Stephens D,Mireskandari K. Prediction of visual outcomes after open globe injury in children:a 17-year Canadian experience. J Aapos 2013;17(1):43-48
13翁孟诗,高慕洁,梁静. 影响眼外伤预后视力恢复的因素分析. 临床眼科杂志2013;21(4):344-346
14朱丽丽. 儿童开放性眼外伤评分系统的建立及其在预后评估中的初步应用. 浙江大学2016
15成洋阳,盛湘云,罗中文. 0～6岁儿童眼病筛查分析. 中国儿童保健杂志2014;22(2):210-212
16 Hoskin AK,Philip SS,Yardley AM,et al. Eye Injury Prevention for the Pediatric Population. Asia-Pacific J Ophthalmol 2016;5(3):202-211
2北京协和医院世界卫生组织疾病分类合作中心. ICD-10疾病和有关健康问题国际统计分类. 北京:人民卫生出版社1996:351-373
3 Pieramici DJ,Jr SP, Sr AT,et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol 1998; 125(4):565-566
4 Kuhn F,Maisiak R, Mann L, et al. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002;15:163-165
5李晓苹,钟梅. 河南省济源市农村儿童眼外伤原因分析. 中华眼外伤职业眼病杂志2015;37(3):215-218
6 Archambault C,Gabias C,Fallaha N,et al. Pediatric ocular injuries: a 3-year review of patients presenting to an emergency department in Canada. Can J Ophthalmol 2018:S0008418217313327
7 Liu ML,Chang YS,Tseng SH, et al. Major pediatric ocular trauma in Taiwan. J Pediatric Ophthalmol Strabismus 2010;47(2):88
8刘金花,陈红,张颖,等. 402例儿童眼外伤临床因素分析. 解放军医学院学报2016;37(6):556-559
9 Serrano JC,Chalela P,Arias JD. Epidemiology of Childhood Ocular Trauma in a Northeastern Colombian Region. Arch Ophthalmol 2003;121(10):1439-1445
10张曼姝. 儿童眼外伤的致伤因素与特征分析. 郑州大学2014
11梁春. 儿童眼外伤282例临床分析. 中国民族民间医药2010;19(24):145
12 Bunting H,Stephens D,Mireskandari K. Prediction of visual outcomes after open globe injury in children:a 17-year Canadian experience. J Aapos 2013;17(1):43-48
13翁孟诗,高慕洁,梁静. 影响眼外伤预后视力恢复的因素分析. 临床眼科杂志2013;21(4):344-346
14朱丽丽. 儿童开放性眼外伤评分系统的建立及其在预后评估中的初步应用. 浙江大学2016
15成洋阳,盛湘云,罗中文. 0～6岁儿童眼病筛查分析. 中国儿童保健杂志2014;22(2):210-212
16 Hoskin AK,Philip SS,Yardley AM,et al. Eye Injury Prevention for the Pediatric Population. Asia-Pacific J Ophthalmol 2016;5(3):202-211