眼球贯通伤的临床特征及治疗效果分析

Analysis on the clinical characteristics and treatment of double perforation of eye ball

目的分析眼球贯通伤的临床特点及其治疗效果。方法回顾性分析2011年10月至2016年6月眼球贯通伤41例（41只眼）的临床资料。观察致伤物、伤口位置、大小和缝合及眼部受伤情况等。随访6个月。结果眼球贯通伤占同期开放性眼外伤的1．07％（41／3832）。年龄3～60岁，平均（36．12±12．78）岁。其中男35例，女6例。右眼17例，左眼24例。金属飞屑击伤32例（78．05％），钢丝刺伤3例，气枪子弹伤2例，其它4例。6例行眼内容摘除，35例行二期手术重建眼球。治疗后视力明显改善（χ2=17．277，P=0．001）。入口长度〈5mm组术后视力优于≥5mm组（χ2=20．949，P=0．000）。出口距离“视盘．盘斑束一黄斑中心凹”1DD以内组术后视力低于1～2DD组（χ2=11．246，P=0．010）和〉2DD组（χ2=14．221，P=0．003）。结论眼球贯通伤是严重眼外伤，但经及时治疗，多数能重建眼球结构，恢复部分有用视力。

Objective To analyze the clinical characteristics and treatment of double perforation of eye ball. Methods The data of 41 eyes of 41 cases of double perforation of eye ball from Oct. 2011 to Jun. 2016 were analyzed retrospectively. The causes, injuries of the globe, and the entrance and exit wound were recorded and compared. The follow-up time was 6 months. Results The cases of double perforating eye injury occupied 1.07% of 3 832 cases of open-globe injury at the same period. The age ranged from 3 to 60 years, averagely （36.12 ± 12.78） years. There were 35 males and 6 females. There were 17 cases in right eye and 24 cases in left eye. The cause of injury was metal foreign body in 32 cases （78.05%） , steel wire stabing in 3 eases, air-gun ball in 2 cases and other causes in 4 cases. Six cases received enucleation, the other 35 cases received secondary surgery for reconstruction of the globe. The postoperative BCVA was improved （χ2 = 17. 277, P = 0. 001 ）. The postoperative BCVA in the group of the entrance wound length 〈 5 mm was better than that in the group of the entrance wound length ≥ 5 mm （χ2 = 20. 949, P = 0. 000）. According to the distance between the site of the exit wound and ＇ disc-to-fovea＇ zone, the BCVA of group with distance 〈 1 DD was poorer than that of the 1-2 DD group （χ2 = 11. 246, P = 0. 010） and 〉 2 DD group （χ2 = 14. 221 ,P =0.003 ）. Conclusion Double perforation of eye ball is a kind of severe eye injury. But the globe could be reconstructed and useful visual acuity could be restored if treatment was done properly and promptly.