早期前房穿刺放液治疗重度外伤性前房积血

Early anterior chamber paracentesis for the treatment of severe traumatic hyphema

目的评价早期前房穿刺放液治疗重度外伤性前房积血的效果。方法对60例（60眼）重度外伤性前房积血，按年龄进行分层随机分为两组，分别行早期前房穿刺放液及保守治疗，观察前房积血后眼压变化、积血吸收时间、瞳孔大小变化及视力恢复情况。结果重度外伤性前房积血伤后早期83．3％出现眼压升高，早期前房穿刺放液组眼压下降明显，与保守治疗组相比差异有统计学意义（P〈0．05）。早期前房穿刺放液组积血平均吸收时间为（5．57±1．28）d，与保守治疗组的平均（10．00±1．91）d相比差异有统计学意义（P〈0．05）。早期前房穿刺放液组有3例出现瞳孔散大，保守治疗组有11例出现瞳孔散大，两组差异有统计学意义（P〈0．01）。早期前房穿刺放液组治疗后平均视力0．84±0．45，保守治疗组愈后平均视力0．61±0．46，两组差异有统计学意义（P〈0．05）。结论重度前房积血早期行前房穿刺放液可加快积血吸收，减少并发症，获得较好的视力恢复。

Objective To evaluate the efficacy of early paracentesis of anterior chamber for the treatment of severe traumatic hyphema. Methods Sixty eyes of 60 cases with severe traumatic hyphema were randomly divided into two groups. Early anterior chamber paracentesis was performed in group Ⅰ , and conservative method was used in group Ⅱ. The intraocular pressure （ IOP）, blood absorption time, pupil and visual acuity were observed. Results High IOP occured in patients who accounted for 83.3 % in the early stage of severe traumatic hyphema. The IOP in group Ⅰ decreased obviously, and compared with group Ⅱ , the difference was statistically significant（P 〈0.05）. The blood was absorbed in an average time of （5.57 ±1.28） d in group I , （ 10.00 ±1.91 ） d in group Ⅱ ,and the difference between them was statistically significant（ P 〈 0.05 ）. Mydriasis occured in 3 patients in group Ⅰ and Ⅱ patients in group Ⅱ , there was a sta- tistically significant difference between two groups（ P 〈 0.05）. The average visual acuity after treatment was 0.84 ± 0.45 in group Ⅰ , 0.61 ± 0.46 in group Ⅱ, and the difference between them was statistically significant （ P 〈 0.05 ）. Coneluslon Early paracentesis of anterior chamber for severe traumatic hyphema can accelerate the absorption of blood, reduce complications, and achieve better visual acuity.