40例外伤性前房积血临床治疗分析

Analysis of 40 cases of traumatic hyphema clinical treatment

目的研究外伤引起的眼球前房积血的治疗方法。方法选择2009年4月至2012年2月于我院眼科进行治疗的外伤性前房积血的40例患者,对其进行止血、降眼压、包扎、半卧位休息等对症治疗,采用促进细胞代谢药物及自由基清除剂应用,球结膜下注射地塞米松联合玻璃酸酶,必要时行前房穿刺冲洗。结果 21例I级患者前房积血均于3d内吸收;11例Ⅱ级患者中有8例7d内吸收,4例10d内吸收,8例ⅡI级患者前房积血平均11.8d内吸收。I级和Ⅱ级前房积血患者治疗后视功能恢复佳,ⅡI级视功能恢复较差。结论外伤性前房积血经早期积极恰当治疗,可使积血较快吸收,较大限度的恢复视功能,减少角膜血染、继发性青光眼等并发症。

Objective To study the injury caused by eye hyphema treatment method. Methods In A- pril 2009 to February 2012 in the department of ophthalmology in our hospital for the treatment of traumatic hyphema in 40 cases, the hemostasis,lowering intraocular pressure, bandaging, half supine rest and other sym- potomatic treatment with drugs, and promote cell metabolism and free radical scavenger application, subcon- junctival injection of dexamethasone combined with hyaluronidase, paracentesis of anterior chamber irrigation if needed. Results 21 cases of class I hyphema were absorbed in three days, 11 cases of class II in eight cases within seven days of absorption, four patients within ten days of absoption, eight cases of patients with stage III hephema absoption averaged 11.8 days. I grade and II grade hyphema after treatment in patients with good func- tional recovery, Ⅲ level of visual function recovery was poor. Conclusion Traumatic hyphema by early active treatment, can make the blood faster absoption, greatly restored visual function, reduce blood staining of corne- a, complications such as secondary glaucoma.