急诊手术治疗角巩膜穿通伤的临床体会

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1、急诊手术治疗角巩膜穿通伤的临床体会急诊手术治疗角巩膜穿通伤的临床体会［摘要］目的观察急诊手术治疗角巩膜穿通伤的应用效果。方法角巩膜穿通伤患者56例(56只眼)，清创缝合术时，联合色索膜复位术29只眼，虹膜根部离断缝合修补术3只眼，前房形成术19只眼，前房冲洗术8只眼，白内障囊外摘除术20只眼，白内障囊内摘除+前段玻璃体切割术4只眼，玻璃体磁性异物取出术3只眼，白内障囊外摘除+品状体异物取出术4只眼。结果56例(56只眼)患者中5只眼视力无恢复，其中包括术前视力无光感2只眼，光感3只眼；51只眼均恢复了部分视力。术后视力：无光感者2只眼，

2、光感〜0.02者18只眼，0.02~0.1者23只眼，0.1〜0.3者9眼，0.3以上者4只眼。结论急诊手术时娴熟技术水平和恰当手术方案可提高患者伤眼视功能恢复的可能性。［关键词］角巩膜穿通伤；急诊手术；临床体会［中图分类号］R772.2［文献标识码］B［文章编号］1674-4721(2014)09(a)-0175-03ClinicalexperiencewithemergencysurgicalintreatmentofcornealandscleralpenetratinginjuryQIUYan-feiHEJian-zhongLA

3、NTingLAIWeiZHONGMinDepartmentofOphthalmology,People7sHospitalofPingxiangCityinJiangxiProvince,Pingxiang337055,China［Abstract］ObjectiveToobservetheeffectofemergencysurgicalinthetreatmentofcornealandscleralpenetratinginjury.Methods56casesofpatientswithcornealwithscleralinj

4、ury(56eyes)underwentdebridementandsuturing,29eyesamongthetotalwerecombinedwithrepositionofiris,3eyeswerewithiridodialysisreposition,19eyeswerewiththeanteriorchamberre-formedoperation,8eyeswerecombinedwithanteriorchamberwashout,20eyeswerewiththeextracapsularcataractextrac

5、tion,4eyeswerewiththeintracapsularcataractextractionwiththeanteriorvitrectomy,3eyeswerecombinedwiththeextractionofforeignbody,4eyeswerewiththeintracapsularcataractextractionwithcrystalforeignbodyremova1.ResultsInthe56patients(56eyes),therewere5eyeshadvisualimpairment,ine

6、ludingpreoperativevisionwerenolightperceptionin2eyes,lightperceptiontin3eyes,thevisualacuitywasimprovedin51eyes.Postoperativevision：nolightperceptionin2eyes,18eyeswereWO.02,23eyeswere0.02-0.1,9eyeswere0.1-0.3,4eyeswere$0.3.ConclusionWheninemergencyoperation,skilledoperat

7、ionalabilityandproperoperationschemecanincreasethepossibilityofinjuryeyesrecovery.[Keywords]Corneaandscleralrupture；Emergencysurgicaltreatment；Clinicalexperience角巩膜穿通伤是眼外伤的常见病种之一，由于伤口较大同时穿透角膜和巩膜，通常可引起虹膜睫状体、晶状体及玻璃体的损伤、脱出以及球内出血等其他外伤病变，因此术中除常规缝合角巩膜创口外，常需联合其他种类的手术方式。如果在急诊手术时

8、术式选择不当，会加大二期手术的难度或失去再次手术的机会，最终将明显影响伤眼视功能的恢复。本院眼科通过对角巩膜穿通伤治疗的回顾性分析，对其在急诊情况下的手术治疗方式作总结。1资料与方法1.1-般资料收集本院眼