眼烧伤136例临床分析

Clinical analysis of 136 cases of eye burns.

目的探讨眼烧伤的临床特点及手术效果。方法回顾性分析眼烧伤136例（206眼）的致伤原因、致伤程度、视力、并发症及手术治疗效果。结果碱烧伤最多，热烧伤、酸烧伤次之。206眼中Ⅲ度烧伤107眼，占51．9％；Ⅳ度烧伤16眼，占7．8％。早期行羊膜移植者术后视力0．3及以上者95眼，占69．3％；无严重并发症者38眼，占27．8％。早期未行羊膜移植者视力0．3及以上者29眼，占51．8％；无严重并发症者7眼，占12．5％。化学烧伤者与热烧伤者相比，视力恢复差异无统计学意义（X^2=2．14，P〉0．05），但发生的严重并发症较多（X^2=4．10，P〈0．05）。并发症期接受自体角膜缘移植联合板层角膜移植术者中，视力有显著提高者占79．3％。结论早期诊疗、早期的羊膜移植和晚期的自体角膜缘移植联合板层角膜移植术对于减少并发症发生及术后视力的恢复有重要意义。

Objective To investigate the clinical characteristics and the result of surgery treatments of eye bums. Methods 136 patients （206 eyes） were evaluated retrospectively. The causes, degree of damage, visual acuity, complications and outcome of operation were analyzed. Results Alkali burn was the principal cause（85 eyes, 41.3% ）, thermal burn（77eyes, 37.4% ）and acid burn （36eyes, 17.5% ） were next to it. Most patients were severely burned, among them, 107（51.9% ） were Ⅲ degree burn and 16 were Ⅳ- degree burn. Vision of 95 among 137（69.3% ） eyes with early amniotic membrane transplantation （AMT） recover a vision better than 0. 3, the number was 29 among 56（51.8% ） in group of eyes with non-early AMT. Among eyes with early AMT, 38 eyes （27.8%） didn＇t have severe complications, only 7 eyes （ 12.5% ） didn＇ have severe complications in non - early AMT group. There was no significant difference of vision between chemical bum patients and thermal bum patients （ P 〉 0. 05 ）, while the complications in chemical bum patients were more than that in thermal burn patients （ P 〈 0.05 ）. Most patients （79.3%） at complication stage with limbus auto-graft transplantation combined with laminar keratoplasty can obtain a significantly better vision. Conclusion Early clinical treatment, early AMT and limbus autograft transplantation combined with laminar keratoplasty are very important for eye bums patients to reduce complications and recover a better vision.