B超在穿孔性眼外伤辅助诊断中的作用

The role of B-scan ultrasound in diagnosis of penetrating ocular injury

目的分析B型超声观察穿孔性眼外伤眼球中后段及眶内病变的意义。方法对临床确诊为眼球穿孔伤者，进行B超检查，观察玻璃体腔及球后的影像学变化。结果对129例（129眼）角巩膜穿孔伤，分别为锐器伤，细小异物击伤，钝物击伤，爆炸伤及原凶不明的外伤。B超探查发现轻微玻璃体浑浊73例，占56．59％；单纯玻璃体积血浑浊12例，占9．30％；眶内异物25例，占19．38％；玻璃体积血合并脉络膜脱离6例，占4．65％；玻璃体积血合并视网膜脱离6例，占4．65％；玻璃体积血合并视网膜脱离及脉络膜脱离7例，占5．43％。结论眼球穿孔伤多数伴有外伤性虹膜睫状体炎、外伤性白内障或玻璃体积血等影响眼底检查的因素，B超就成为了解这类患者眼球后段及眶内病变的重要检查方法，为临床诊断及下一步治疗提供重要的依据。

Objective To assess the value of the B-scan on imaging of middle and posterior segment of eyeball, and intraorbital lesion in patients with perforating ocular injry. Methods 129 patients （ 129 eyes） with perforating ocular injury underwent B-scan. We observed the B-scan echography images of vitreous cavity and retrobulhar space. Results The cause of the injury were shalrp instrument injury, tiny foreign body shot, blunt trauma, explosion injry and unknown cause respectively. Lightly vitreous opacity without other obvious damage was found in 73 patients （56.59%） , simple vitreous hemorrhage was found in 12 patients（9.30% ）, intraorbital foreign body was found in 25 patients （19.38%）, vitreous hemorrhage combined choroid detaehment in 6 patients （4.65%） ,vitreous hemorrhage combined retinal detachment in 6 pa- tients （4.65%） ,vitreous hemorrhage combined ehoroid detachment and retinal detachment in 7 patients （5. 43% ）. Conclusion B-scan echography plays an important role in detecting intraocular and retrobulbar lesions of patients with ocular trauma, whieh is of particular value when the refracting media are opacified by traumatic iridocyclitis, traumatic cataract and haemorrhage.