摘要
目的探讨机械性眼外伤分类系统对闭合性眼外伤(closed globe injury,CGI)预后评价的意义。方法连续入选2005年2月至2007年2月住院CGI 120例(124眼),对眼外伤的类型(根据损伤机制)、程度(根据损伤后最初视力)、区域(根据损伤的解剖位置)、相对性瞳孔传入障碍(RAPD),及其他可能影响预后的前房积血、外伤性虹膜炎、外伤性白内障、玻璃体积血及就诊延迟时间进行单因素及多因素逐步Logistic回归分析,以观察对预后视力的影响。结果病例随访至少6个月,预后好(视力≥0.5)86眼占69.35%,预后差(视力<0.5)38眼,占30.65%。单因素分析显示:损伤程度(P=0.000)、损伤区域(P=0.000)、RAPD(P=0.000)、玻璃体积血(P=0.004)、就诊延迟时间(P=0.04)是影响预后视力的危险因素,而在多因素逐步Logistic回归分析之后显示:损伤程度(P=0.000,OR=3.95395%CI=2.01-7.79)、RAPD(P=0.002,OR=6.55,95%CI=1.98-21.61)及损伤区域(P=0.005,OR=3.59,95%CI=1.47-8.80)是影响预后视力的独立危险因素。结论损伤程度、区域及RAPD是影响CGI视力预后的主要因素。机械性眼外伤分类系统有助于CGI的预后判断。
Objective To evaluate prognostic factors for visualoutcome in closed-globe injury involving the variables of a system for classifying mechanical injuries of the eye and the additional variables. Methods Medical records of 120 consecutive patients（ 124 eyes） with closed-globe injury were retrospectively reviewed. Specific variables of asystem for classifying mechanical injuries of the eye were analyzed ： the type of injury （ defined by the mechanism of injury） , grade of injury （defined by initial visual acuity）, zone of injury （defined by the anatomiclocation of the trauma）, and relative afferent pupillary defect. Additionalvariables, such as hyphema, traumatic iritis, traumatic cataract, vitreoushemorrhage, and elapsed time between the injury and presentation were also included in the analysis. Final visual outcome were recorded. Data were analyzed for predictors with univariate analysis and multivariatelogistic regression analysis. Results After a follow up of 6 months, 86 eyes（69. 35% ） achieved visual acuity 0. 5 or better, 38 eyes （30.65%） achieved visual acuity worse than 0.5. According to univariate analysis results, the following parameters were predictors of visual outcome： grade of injury （P =0. 000）, zone of injury （P = 0.000） , afferent pupillary response （ P= 0. 000 ） , vitreous hemorrhage （ P = 0.004 ）, elapsed time （ P = 0.04 ） However, multivariate logistic regression analyses revealed that grade of injury （ P=0. 000, OR = 3.95,95% CI = 2.01 - 7.79 ）, relative afferentpupillary detect（P= 0.002, OR = 6.55, 95% CI = 1.98 - 21.61 ） and zone of injury （P=0.005, OR =3.59, 95% CI=1.47-8.80） were the only significant factors for visual outcome. Conclusion Grade of injury, zone of injury and relative afferent pupillary defect were significant prognostic factors for visual outcome in closed-globe injury. The classification systemmay become useful prognostic tool for visual outcome in closed-globe injury.
出处
《眼外伤职业眼病杂志》
2010年第4期267-270,共4页
Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries
关键词
闭合性眼外伤
分类系统
预后
视力
classification system
closed-globeinjury
prognosis
visual acuity
