医源性眼部损伤临床分析

Clinical analysis of iatrogenic ocular injury

目的 探讨医院内医源性眼部损伤的原因与防护措施.方法 回顾性分析26例（41眼）医源性眼部损伤,分析其一般情况、眼损伤分类、损伤原因及处理方法及结果.结果 医源性眼部损伤26例（41眼）,年龄6～68岁,单眼伤者11例,双眼伤者15例,左右眼例数相近.眼损伤原因主要是护理缺陷、手术并发症、麻醉并发症3个方面.大部分是轻度损伤,经过对症治疗,获得痊愈.重度损伤3例（3眼）.泪道损伤者,试行泪道探通,探通失败,则行泪囊鼻腔吻合手术治疗.伴有视力严重损害者,尽快查明原因,进行针对性药物治疗或手术治疗,仍有部分病例,疗效不佳.结论 避免或减轻损伤的关键在于预防,一旦出现,应积极请专科会诊,以协助治疗.

Objective To investigate the causes and preventive measures of iatrogenic eye injury. Methods 41 eyes of 26 cases with iatrogenic eye injury were retrospectively analyzed. The condition, classification, causes, treatment and outcomes were analyzed. Results Iatrogenic eye injuries mostly occurred in male aged 6 to 68 years old. The main causes of iatrogenie eye injury were nursing errors, operative complication and complication of anesthesia. Most iatrogenic eye injuries were mild, and healed after giving symptomatic treatment. Severe injury occurred in 3 cases. Probing of lacrimal passage was performed for lacrimal duct injury firstly and if it failed a dacryocystorhinostomy should be tried. For patients with severe visual damage, the cause of visual damage should be found out as soon as possible, and then , drug therapy or surgery were performed. But even by doing this the vision of some cases was still poor. Conclusion The key to avoid iatrogenic ocular injury is prevention. Timely special consultation and effective treatment are necessary to iatrogenic injury.