少年儿童锐器伤致感染性眼内炎的临床分析

Clinical analysis on characteristics of infective endophthalmitis due to sharp material injury in children and juveniles

目的分析少年儿童锐器伤致感染性眼内炎的临床特征.方法回顾性分析河北省眼科医院眼外伤科2012年1月至2017年12月共42例(42只眼)少年儿童锐器伤致感染性眼内炎的临床资料.术后随访12个月.结果本组中男35例,女7例.年龄范围1~18岁,平均(7.04±3.97)岁.致伤物学龄前组主要是剪刀,学龄组主要是学习用具,少年组则以铁丝为主.最常见的临床表现为外伤性白内障.术前视力:无光感者2例,光感~手动者32例,数指~0.04者4例,0.05~0.25者2例,0.3~0.5者2例.术后视力:无光感者2例,光感~手动者18例,数指~0.04者13例,0.05~0.25者5例,0.3~0.5者2例,≥0.6者2例.手术前后视力差异有统计学意义(Z=2.248,P=0.025).结论剪刀、学习用具和铁丝分别是学龄前、学龄儿童和少年感染性眼内炎最常见的锐器致伤因素.玻璃体内注药术和玻璃体切除术是治疗少年儿童感染性眼内炎的最佳方案.

Objective To analyze the clinical characteristics of infective endophthalmitis due to sharp material injury in children and juveniles.Methods A retrospective study.The data of 42 eyes of 42 children with infective endophthalmitis caused by sharp material injury from Jan.2012 to Dec.2017 in Hebei Provincial Eye hospital were analyzed.All patients were followed up for 12 months after surgery.Results There were 35 males and 7 females.The age ranged 1 to 18 years,with average of(7.04±3.97)years.The cause of sharp material injury in preschool group were mainly scissors,learning instrument in the school age group,and iron wire in the juveniles group.The most common clinical characteristics was traumatic cataract.Preoperative visual acuity was no light perception(NLP)in 2 cases,light perception(LP)-hand movement(HM)in 32 cases,counting finger(CF)-0.04 in 4 cases,0.05-0.25 in 2 cases,0.3-0.5 in 2 cases.Postoperative visual acuity was NLP in 2 cases,LP-HM in 18 cases,CF-0.04 in 13 cases,0.05-0.25 in 5 cases,0.3-0.5 in 2 cases,≥0.6 in 2 cases.The difference was statistically significant between before and after surgery(Z=2.248,P=0.025).Conclusion Scissors,learning instrument and iron wire are the most common causes of infective endophthalmitis due to sharp material injury in preschool,school-age children and juveniles,respectively.Intravitreal injection and vitrectomy are the best treatment for infective endophthalmitis in children and juveniles.