摘要:目的:总结儿童眼球钝挫伤致前房积血的原因、临床表现以及最佳治疗方法。方法: 回顾分析四川大学华西医院2007年9月~2008年9月收治的眼球钝挫伤致前房积血23例的治疗:(1)半卧位休息;(2)双眼包扎或不包扎;(3)止血;(4)手术治疗。 结果: Ⅰ、Ⅱ级前房积血吸收快,出现继发性出血者常需要采取手术治疗,视功能恢复缓慢。结论: 早期积极恰当治疗,可减少继发性青光眼、角膜血染等并发症。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.
Tweenty-seven cases (27 eyes) of retinal detachment and change of anterior chamber angle induced by contusional eye injuried were reported ,in which there were 23 eyes with obviously visible recession of the chamber angle, and 10 eyes with adherent lesions in the chamber angle, The position of retinal holes and detachment of retina as well as changes of anterior chamber angle in majority of cases located at the sites of trauma or the quadr ants opposite to them. The proportions of retinal detachment due to dialysis of ora sen'am or round retinal holes were found to be high in this series of cases,and the round holes were found in injured eyes with relatively long courses of ocalar trauma. Owing to the close interrelationship between rbegmatogenous retinal detachment and the anterior chamber angle lesions after the eontusional ocular injuries,it was suggested that the chamber angle changes might be used as one of the important referential indicators in diagnosis of traumatic retinal detachment induced by blunt ocular injuries. （Chin J Ocul Fundus Dis,1993,9:74-76）
目的：观察前房冲洗术联合尿激酶治疗严重外伤性前房积血的临床疗效。方法：选择近3年来我科收治的严重外伤性前房积血患者57例(56眼)，随机分为Ａ组29例(29)眼)、Ｂ组28例(28眼)，Ａ组采用先前房注入尿激酶再行前房冲洗的方法，Ｂ组行单纯前房冲洗术。观察术中及术后并发症；术后视力、眼压情况。结果：Ａ组术中干净清除血凝块29眼(100％)，术中出血5眼(17.24％)，无虹膜损伤，术后第一天矫正视力≥0.5有24眼，眼压≥21 mm Hg者4眼(13.79％)；Ｂ组术中仍有少量血凝块4眼(14.29％)，术中出血4眼(14.29％)，虹膜损伤1眼(3.57％)，术后第一天矫正视力≥0.5有16眼，眼压≥21 mm Hg者8眼(28.57％)。Ｂ组术后仍有少量血凝块者加用药物治疗后吸收，两组病例中高眼压均加用药物控制正常，一周时视力无明显差异(P＞0.05)。结论：前房冲洗术前先使用尿激酶治疗严重外伤性前房积血是一种操作更安全，更有效的手术方法。