正确认识儿童开放性眼外伤诊疗的复杂性,不断提高其诊疗效果

Correctly understanding the complexity of diagnosis and treatment of children's open ocular trauma to improve its diagnosis and treatment effect

儿童开放性眼外伤是引起儿童非先天性单眼致盲的主要原因。儿童的心理和日常活动与成人不同;眼部组织结构尚未发育成熟且对损伤的高反应性及对各种诊疗手段的不配合性等特点决定了儿童开放性眼外伤在致伤因素、致伤环境、诊疗和预后等方面均较成人更为复杂。对于儿童开放性眼外伤的急诊一期和二期诊疗,应在遵循成人开放性眼外伤处置原则的前提下,结合儿童自身特点,尽量做到手术前明确眼外伤解剖定位、一期手术闭合伤口的同时尽量减少眼内组织扰动、二期手术时机和手术设计个体化,同时手术后用药和护理也应结合儿童特点。儿童眼外伤重在预防,新信息时代下应充分利用临床研究和公共信息平台,推进儿童眼外伤流行病学研究,更加科学地指导儿童眼外伤防治体系建设。

Open ocular trauma in children is one of the main causes of non-congenital monocular blindness in children.Children’s psychological and daily activities are different from those of adults;the eye tissue structure is not maturely enough,and the characteristics of high response to injury and incompatibility with various diagnostic and treatment methods determine the factors that cause injuries and injuries in children with open ocular trauma.The environment,diagnosis and treatment,and prognosis of children are more complicated than adults.For the emergency of first and second stage on diagnosis and treatment of children with open ocular trauma,it should follow the principles of adult open ocular trauma management,combined with the children's characteristics,clarifying the anatomical location of the ocular trauma before surgery,and closing the wound during the first-stage operation.At the same time,the disturbance of intraocular tissue should be minimized,the timing of the second stage operation and the individualization of the operation design,and the medication and care after the operation should also be combined with the characteristics of children.Prevention of ocular trauma in children is the focus of attention.In the new information era,clinical research and public information platforms should be fully utilized to advance the epidemiological study of children's ocular trauma and guide the construction of the prevention and treatment system for children's ocular trauma more scientifically.