早期前房冲洗术治疗前房积血45例临床观察

Clinical observation of early anterior chamber irrigation in the treatment of 45 hyphema cases

目的观察早期前房冲洗术治疗外伤性前房积血的临床疗效,探讨前房积血的手术时机。方法 45例眼球钝挫伤前房积血患者进行早期前房冲洗术,观察患者的临床疗效。结果患者入院时最佳矫正视力为光感~0.4,平均(0.18±0.09),出院时最佳矫正视力为0.2~1.0,平均(0.35±0.02);出院时最佳矫正视力与入院时比较差异有统计学意义(P<0.01)。所有手术患者无一例眼内炎、虹膜脱出损伤、晶状体损伤等严重手术并发症。术后1例患者前房出血增多,1例并发继发性青光眼,其余患者术后眼压均达到正常,术后3 d内前房完全清亮。所有患者无一例患者发生角膜血染。结论早期前房冲洗术对眼球钝挫伤前房积血具有显著的疗效,能够快速提高患者视力,控制眼压,减少患者住院时间,早日明确眼后段病变,及时进行诊治。

Objective To observe clinical effect by early anterior chamber irrigation in the treatment of traumatic hyphema, and to investigate operation opportunity for hyphema. Methods A total of 45 patients with blunt ocular trauma and hyphema received early anterior chamber irrigation, and their clinical effects were observed. Results The patients at admission had best corrected visual acuity as light perception^0.4, with an arerage of（0.18±0.09）, and their best corrected visual acuity at discharge was 0.2~1.0, with an average of（0.35±0.02）. The best corrected visual acuity at discharge had statistically significant difference comparing with that of at admission（P〈0.01）. There was no case with severe operation complications of endoophthalmitis, iris prolapsed and injury, and lens injury. After operation, there were 1 case with increased hyphema and 1 case with secondary glaucoma. All the other patients had normal postoperative intraocular pressure and complete clear anterior chamber within postoperative 3 d. None of the patients had corneal blood staining. Conclusion Early anterior chamber irrigation provides excellent effect in the treatment of blunt ocular trauma and hyphema, and it can effectively improve vision in patients, control their intraocular pressure and shorten hospital stay time. This method can provide early confirmation for further lesion, along with early diagnosis and treatment.