钝伤性前房出血118例回顾分析

摘要

目的:寻找因钝器损伤导致前房积血的原因、视力损伤等相关情况,并探讨治疗后的并发症及预后视力情况.方法:回顾性分析在马来亚大学医疗中心(马来西亚吉隆坡)治疗的因钝器损伤导致前房积血118例患者.从患者的病情记录获取患者的性别、年龄、种族、钝伤导致的积血原因、眼附属物、入院视力、相关眼科情况、并发症和视力结果等资料,并采用SPSS软件进行分析.结果:男性受累居多,占93.2%,有2/3患者(67.8%)年龄<30岁.运动相关的伤害(38.1%)是最常见的前房积血原因.66.9%的患者5d内前房出血消失.虹膜损伤非常普遍,包括括约肌撕裂,虹膜根部断离等,而并发玻璃体出血患者约占11.9%.住院期间,二次观察出血的患者为3.4%.在最后的随访中视力≥6/18的最佳矫正视力占85.4%.这些患者随访不到位导致继发性青光眼的发病率无法确定.中度角膜血染患者约占0.8%.结论:在马来西亚,运动相关的损伤是前房出血最常见的原因.适当和及时的治疗能使钝伤性前房积血患者具有良好的视力,且无严重并发症发生.%AIM: To determine the causes, associated ocular findings and visual acuity on presentation, complications and visual outcome following treatment in patients of hyphema due to blunt injury METHODS: A retrospective study was performed in 118 patients with hyphema due to blunt injury admitted in University of Malaya Medical Centre, Kuala Lumpur,Malaysia. The gender, age, race, cause of blunt injury resulting in hyphema, eye involved, vision at admission,other associated ophthalmological findings, complications and visual outcome were noted from the case records of patients. The data were analyzed using SPSS programme.RESULTS: Males were more predominantly affected (93.2%). Over two-thirds of patients (67.8%) were aged below 30 years. Sports related injury (38. 1%) was the most common cause for hyphema. Hyphema disappeared within 5 days in 66.9% of patients. Iris injuries were very commonly associated in the form of mydriasis, sphincter tear and iridodialysis. Associated vitreous haemorrhage was noted in 11.9% of patients. During the hospital stay,secondary haemorrhage was observed in 3. 4% of patients. The best corrected vision of 6/18 or better was noted in 85. 4% of patients at the last follow-up. The follow-up of these subjects was very poor and thus the incidence of secondary glaucoma could not be established. Moderate blood staining of cornea occurred in 0.8% of patients.CONCLUSION: Sports related injury is the most common cause of hyphema in Malaysia. Good visual recovery, without serious complications, is possible with appropriate and in-time treatment in hyphema patients due to blunt injury.