春节眼外伤临床特征和伤情预后分析

Clinical features and prognosis of ocular injuries during Spring Festival

摘要:

目的：总结近5a春节期间眼外伤患者的临床资料，分析伤情对视力预后的影响。

方法：收集2013/2017年春节国家法定假日期间(农历除夕至初六)及假日前后各10d内我院收治的眼外伤患者的临床资料，总结伤者年龄、性别、居住地、就诊时间、致伤原因、外伤性质等情况及变化趋势，分析眼外伤性质对视力预后的影响，探讨眼外伤评分与患者住院日、住院费用的关系。

结果：纳入眼外伤患者155例158眼，男女比例为6.05：1； 30～44岁人群受伤比例最高； 城镇人群眼外伤发生率低于农村人群，但前者较后者更能及时就诊，就诊时间差异有统计学意义(Z=-3.232，P<0.01)； 春节假日期间眼外伤人数增加，烟花爆竹为主要致伤原因(41.9%)，其次是玩具枪致伤(16.1%)，后者也是儿童主要致伤原因； 闭合性眼外伤占较高比例(76.6%)； 单纯保守药物治疗71眼(44.9%)，多数患者需手术干预； 开放性眼外伤患者较闭合性眼外伤患者伤情评分低(Z=-5.249，P<0.01)，且盲目率更高； 本组患者出院时视力较入院时明显提高，差异有统计学意义(Z=-7.487，P<0.01)； 住院费用随住院日增加而增加，两者呈正相关(r_s=0.755，P<0.01)，眼外伤评分(77.41±16.96分)与住院费用呈负相关(r_s=-0.474，P<0.01)，与住院日呈负相关(r_s=-0.359，P<0.01)。

结论：春节期间眼外伤多发于中年男性和农村人群，燃放烟花爆竹为主要致伤原因； 眼外伤可损害眼球形态和视功能，外伤性质和及时诊治对视力预后有重要影响； 眼外伤伤情越重，住院日和住院费用相应增加，加重个人和社会负担。

Abstract:

AIM: To summarize and analyze the clinical data of patients with ocular injuries during Spring Festival in the past five years, and analyze the effect of injury on the patient and visual outcome.

METHODS: The clinical data of 155 cases of ocular trauma admitted during the Spring Festival from 2013 to 2017 were collected, including their age, sex, place, course, causes, nature of trauma, etc. The clinical features and the trends of ocular traumas in each year were summarized, and analysis the impact of injury on the vision prognosis, probe the relationship between ocular trauma sore and hospitalization days and costs.

RESULTS: A total of 155 ocular trauma patients(158 eyes)were enrolled in this study. The ratio of male to female was 6.05: 1, the mean age was 34.8±20.0 years old, and the proportion of 30-44 years old was higher. There were more rural residents than urban residents, showing differences on the course of injury(Z=-3.232, P<0.01). The general trend was that the number of people injured in the Spring Festival holidays increased. Fireworks were the main cause of injury, accounting for 41.9%, followed by toy gun injuries(16.1%), and the latter was the main cause of child injury. Closed globe injury accounted for a large proportion(76.6%)). Conservative treatment were needed for 71 eyes(44.9%), the majority patients still for surgery intervention. Open globe injury of ocular trauma sore was lower than closed globe injury(Z=-5.249, P<0.01), and the blindness rate of the former was higher. The visual acuity on discharge was significantly higher than admission(Z=-7.487, P<0.01). Hospitalization expenses increased with the number of hospitalization days, and both were positively correlated(r_s=0.755, P<0.01). The average ocular trauma sore was about 77.41±16.96, which was negatively correlated with hospitalization costs(r_s=-0.474, P<0.01)and negative correlation with hospitalization days(r_s=-0.359, P<0.01).

CONCLUSION: During the Spring Festival, ocular trauma occurred in middle-aged men and rural population. Fireworks were the main cause of injury. The eyeball shape and visual function was damaged after ocular trauma. Timely diagnosis and treatment could save the visual function of some patients. The heavier the injury, the higher the hospital days and hospitalization costs, which increased the personal and social burden.