本文關(guān)鍵詞： 眼外傷 眼爆炸傷 臨床分析　出處：《山西醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的：了解眼爆炸傷的流行病學(xué)狀況,分析眼爆炸傷的發(fā)生原因及影響視力的危險因素,以期提出防治措施。 方法：對山西醫(yī)科大學(xué)第一、二醫(yī)院眼科2005年1月-2009年12月期間住院的眼爆炸傷患者的病例資料作一回顧性研究。 結(jié)果：住院患者114例(196眼),占同期眼外傷住院病例總數(shù)512例的22.3%。年齡最大者77歲,最小者5歲,平均年齡33.9±11.4歲。男性眼爆炸傷患者明顯多于女性,31-40歲是眼爆炸傷高發(fā)年齡段。男性108例,占94.7%,女性6例,占5.3%,男女之比為18/1,二者有顯著性差異。右眼17例,左眼15例,雙眼82例(164眼)。就診時以角膜、鞏膜穿孔傷、外傷性白內(nèi)障、眼內(nèi)異物和視神經(jīng)損傷為多。眼瞼裂傷42例,角結(jié)膜異物58例,眼球內(nèi)異物31例,眶內(nèi)異物6例,前房出血52例,角膜裂傷45例,鞏膜裂傷10例,角鞏膜裂傷21例,虹膜根部離斷10例,嚴重眼球破裂、內(nèi)容物脫出38例,晶體脫位4例,外傷性白內(nèi)障26例,眶骨骨折5例,合并全身其它部位損傷38例(54眼)占33.3%。治療后27例(29眼)行眼內(nèi)容物剜除術(shù),占23.6%。雙眼盲35.4%(58/164),雙眼致殘率43.9%(72/164)。單眼致盲率46.9%(92/196),單眼致殘率41.3%(81/196)。眼爆炸傷的主要原因是雷管及炸藥的爆炸。39.5%的患者由于雷管的爆炸,多是煤礦井下作業(yè)造成。其中56.1%與職業(yè)有關(guān)。其次是鞭炮(23.7%),鞭炮炸傷有明顯的季節(jié)性,主要集中于每年的—二月份。其它眼爆炸傷原因包括炸藥、高壓鍋和爆炸物不詳。 結(jié)論：眼爆炸傷是一種傷情嚴重且復(fù)雜的眼外傷,致盲及致殘率較高,常合并其他器官的損傷。眼球破裂及視神經(jīng)和視網(wǎng)膜損傷是影響視力恢復(fù)的主要因素。正確及時的手術(shù)和治療能使部分患者保留一定的視力。山西是我國的能源基地,工礦企業(yè)較多,雷管及炸藥爆炸是導(dǎo)致工人及青壯年眼爆炸傷的主要原因,這與經(jīng)濟高速發(fā)展但防范措施相對落后有關(guān),加強勞動保護是發(fā)展中國家目前防止眼爆炸傷的首要任務(wù)。
[Abstract]:Objective: to investigate the epidemiological status of ocular explosion injury, analyze the causes of eye explosion injury and the risk factors affecting visual acuity, and propose preventive measures. Methods: a retrospective study was made on the cases of eye explosion injury in the first and second Hospital of Shanxi Medical University from January 2005 to December 2009. Results: 114 cases (196 eyes) were hospitalized, accounting for 22.3% of the 512 cases of ocular trauma in the same period. The oldest was 77 years old, the youngest was 5 years old. The mean age was 33.9 鹵11.4 years. The age of ocular explosive injury in male patients was significantly higher than that in females aged 31-40 years. 108 cases of males (94.7%) were male, 6 cases of females (5.3%), the ratio of male to female was 18 / 1, there was a significant difference between them, 17 cases of right eye and 15 cases of left eye. Most of them were cornea, perforated sclera, traumatic cataract, intraocular foreign body and optic nerve injury. There were 42 cases of eyelid laceration, 58 cases of cornea conjunctiva foreign body, 31 cases of intraocular foreign body, 6 cases of intraorbital foreign body and 52 cases of anterior chamber hemorrhage. There were 45 cases of corneal laceration, 10 cases of scleral laceration, 21 cases of keroscleral laceration, 10 cases of iridotomy, 10 cases of severe ocular rupture, 38 cases of ocular rupture, 4 cases of lens dislocation, 26 cases of traumatic cataract and 5 cases of orbital fracture. 38 cases (54 eyes) complicated with injury of other parts of the body (33. 3%). After treatment, 27 cases (29 eyes) underwent enucleation of the contents of the eye. Accounting for 23.6.The binocular blindness is 35.45.58 / 164m, the binocular disability rate is 43.9. the rate of binocular blindness is 46.9. the rate of blindness is 46.90.The rate of single-eye disability is 41.31.31,81- 164.The main cause of eye explosion is detonator and explosive explosion .39.5% of the patients suffered from detonator explosion. Most of them are caused by underground operation of coal mine. 56.1% of them are related to occupation. The second is firecracker blast injury, which is obviously seasonal, mainly concentrated in February of each year. Other causes of eye explosion injury include explosives, pressure cookers and explosives unknown. Conclusion: the ocular explosion injury is a kind of serious and complicated ocular trauma with a high rate of blindness and disability. Eyeball rupture and optic nerve and retina damage are the main factors affecting the recovery of visual acuity. Correct and timely operation and treatment can make some patients retain certain visual acuity. Shanxi is the energy base of our country. There are more industrial and mining enterprises. Detonators and explosive explosions are the main causes of explosive injuries to the eyes of workers and young adults. This is related to the rapid economic development but relatively backward preventive measures. Strengthening labor protection is currently a top priority in developing countries to prevent eye explosion.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.1

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