目的：觀察前房沖洗術聯合尿激酶治療嚴重外傷性前房積血的臨床療效。方法：選擇近3年來我科收治的嚴重外傷性前房積血患者57例(56眼)，隨機分為Ａ組29例(29)眼)、Ｂ組28例(28眼)，Ａ組采用先前房注入尿激酶再行前房沖洗的方法，Ｂ組行單純前房沖洗術。觀察術中及術后并發癥；術后視力、眼壓情況。結果：Ａ組術中干凈清除血凝塊29眼(100％)，術中出血5眼(17.24％)，無虹膜損傷，術后第一天矯正視力≥0.5有24眼，眼壓≥21 mm Hg者4眼(13.79％)；Ｂ組術中仍有少量血凝塊4眼(14.29％)，術中出血4眼(14.29％)，虹膜損傷1眼(3.57％)，術后第一天矯正視力≥0.5有16眼，眼壓≥21 mm Hg者8眼(28.57％)。Ｂ組術后仍有少量血凝塊者加用藥物治療后吸收，兩組病例中高眼壓均加用藥物控制正常，一周時視力無明顯差異(P＞0.05)。結論：前房沖洗術前先使用尿激酶治療嚴重外傷性前房積血是一種操作更安全，更有效的手術方法。
Objective
To observe the axial length and anterior chamber depth in eyes with branch retinal vein occlusion (BRVO).
Methods
Randomly selected 90 eyes of forty-five patients with BRVO were enrolled in this study. There were 25 males and 20 females. The mean age was (46.22±13.45) years. All the patients were underwent examination of visual acuity, slit-lamp microscope, indiophthalmoscope, fundus color photography and fundus fluorescence angiography (FFA). Randomly selected 45 healthy individuals for control group, including 28 males and 17 females. The mean age was (48.24±15.77) years. The axial lengths and anterior chamber depths of affected and fellow eyes of BRVO patients and the eyes of controls were measured using IOL Master. The data were compared by the two sample paired t test.
Results
The mean axial length of the affected eyes in the BRVO group was (22.69±0.99) mm, and that of the fellow eyes group was (22.78±1.24) mm. The difference in axial length between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.355, P＞0.05). The mean axial length of the right eyes in the control group was (23.38±1.32) mm, and that of the left eyes in the control group was (23.37±1.27) mm. The difference in axial length between the left eyes and right eyes in the control group was not significant (t=0.017, P＞0.05), while the difference in axial length between the affected eyes in the BRVO group and the right, left eyes in the control group was significant (t=?2.563, ?2.663; P＜0.05). The mean anterior chamber depth of the affected eyes in the BRVO group was (2.66±0.26) mm, and that of the fellow eyes was (2.65±0.30) mm. The difference in anterior chamber depth between the affected eyes and fellow eyes in the BRVO group was not significant (t=0.089, P＞0.05). The mean anterior chamber depth of the right eyes in the control group was (2.56±0.29) mm, and that of the left eyes was (2.59±0.30) mm. The difference in anterior chamber depth between the left eyes and right eyes in the control group was not significant (t=?0.592, P＞0.05). The difference in anterior chamber depth between the affected eyes in the BRVO group and the right, left eyes in the control group was not significant (t=1.779, 1.778, P＞0.05).
Conclusion
In the affected eyes of BRVO, the axial length is shorter and anterior chamber depth is normal.
摘要:目的:總結兒童眼球鈍挫傷致前房積血的原因、臨床表現以及最佳治療方法。方法: 回顧分析四川大學華西醫院2007年9月~2008年9月收治的眼球鈍挫傷致前房積血23例的治療:(1)半臥位休息;(2)雙眼包扎或不包扎;(3)止血;(4)手術治療。 結果: Ⅰ、Ⅱ級前房積血吸收快,出現繼發性出血者常需要采取手術治療,視功能恢復緩慢。結論: 早期積極恰當治療,可減少繼發性青光眼、角膜血染等并發癥。Abstract: Objective: To summarize the reasons of children hyphema caused by blunt, clinical manifestations, as well as the best method of treatment. Methods: analysing the 23 cases history of eye hyphema from September 2007 to September 2008 in West China Hospital of Sichuan University caused by blunt. The treatments were: (1) semisupine rest; (2) eyes bandaged; (3) to use hemostatic medicine; (4) surgery. Results: Hyphema in Ⅰand Ⅱ class could be absorbed fastly.Secondary hemorrhage often need to be taken for surgical treatment, depending on the slow recovery of vision. Conclusion: Early appropriate and positive treatment can reduce secondary glaucoma, corneal complications such as blood.
