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1.
182例眼外伤相关因素分析   总被引:3,自引:0,他引:3  
眼外伤是多发病 ,是致盲的主要原因之一。眼外伤一旦发生 ,其后果大多比较严重。现将我院 2 0 0 0年元月至 2 0 0 1年6月间共收治眼外伤患者 182例分析报告如下 :1 临床资料  2 0 0 0年元月至 2 0 0 1年 6月间共收治眼病患者 10 14人 ,眼外伤占 182人 ,占住院人数的 17 95 %。其中男性 14 6人占 80 2 1% ,女性 36人占 19 78% ,男女比为 8∶1。年龄最大 75岁 ,最小 3M ;0~ 10岁 14例 (7 69% ) ,11~ 2 0岁 30例 (16 48% ) ,2 1~ 30岁 65例 (35 71% ) ,31~ 40岁5 7例 (31 32 % ) ,40岁以上 16例 (8 79% )。多发年龄段 2 1~ 40岁。眼别…  相似文献   

2.
儿童眼外伤相关因素分析   总被引:2,自引:0,他引:2  
眼外伤是儿童致盲的原因之一。眼外伤一旦发生 ,其后果大多是比较严重的。本文为探讨眼外伤的发生规律及相关因素 ,对我院近年来的病例进行分析如下。资料和方法1 994年 5月~ 2 0 0 0年 1 2月在我院住院的 1 6岁以下儿童 1 4 1 7例 ,其中眼外伤患者 698例 770眼 ,占住院儿童患者的 4 9 2 0 %。男 5 2 8例 5 88眼 ,女 1 70例 1 82眼 ;右眼 31 7眼 ,左眼 30 9眼 ,双眼 72例 ,占1 0 32 %。结  果1 流行病学特征 发生年龄 :学龄期 ( 7~ 1 4岁 ) 4 32例 ,占 61 89%;学龄前期 2 66例 ,占38 1 1 %。眼外伤发生率高峰为 1 2~ 1 3岁和 6…  相似文献   

3.
眼心反射的临床观察   总被引:1,自引:0,他引:1  
由于眼科手术诱发的眼心反射(简称OCR)。可引起明显的心脏功能改变.甚至停搏.我们用动态心电图仪(Holter).观察40例48次手术.结果如下。术前20分钏给病人安放Holter记录盒。从麻醉开始详细记录每一手术步骤的时间.术后用Holter分析仪进行还原扫描分析,将阴性OCR与手术记录时间相对照.确定OCR发生于哪一手术步骤. 出现以下情况均为OCR阳性:①窦性心率瞬间减慢10次或10次以上;②术中新出现的心律失常或术中出现的心律失常平均每小时次数大手术前;③术中出现  相似文献   

4.
眼心反射在不同斜视手术中的临床表现   总被引:9,自引:0,他引:9  
牵拉眼外肌可使心率减慢 ,这种现象首先为As chner和Dagnin于 1 90 8年发现[1] 。以后人们把眼受机械刺激引起迷走神经过度兴奋而导致心律失常的现象称眼心反射。加压眼球或牵拉眼外肌后心率减慢 1 0次以上者称为阳性眼心反射 ,严重者每分钟可减缓 60次 ,甚至停止心跳而死亡。对象和方法 本文 40例共同性内、外斜视患者 ,术前心电图检查均正常。第一组 :2 0例共同性内斜视 ,男性 1 1例 ,女性 9例 ,年龄 9~ 1 2岁 ,行内直肌后徙术。第二组 :2 0例共同性外斜视 ,男性 1 0例 ,女性 1 0例 ,年龄 9~ 1 1岁 ,行内直肌缩短术。均在心电监护仪监…  相似文献   

5.
眼外伤986例调查分析   总被引:3,自引:2,他引:1  
目的 调查总结眼外伤的发病情况 ,以利于眼外伤的防治。方法 回顾分析 1980年 1月~ 2 0 0 0年 12月住院的986例 (997眼 )眼外伤的临床情况 ,根据受伤的年龄、性别、类型、部位、致伤物及并发症 (眼内炎 )等进行统计分析。结果  1~3岁儿童眼外伤 3 87例 ,占住院眼外伤总例数的 3 9 2 5%。男女之比为 2 3 1∶1,统计学处理差异有非常显著性 (P <0 0 1)。 14岁以上眼外伤占 60 75% ,男女之比为 5 11∶1,男女之间有显著性差异 (P <0 0 1)。该年龄段中以 2 3~ 50岁例数最多 ,高达60 89%。结论 儿童眼外伤应由家长和学校配合 ,积极教育防治。青年及成人应加强公德和劳动保护的双重教育。眼外伤的预后与致伤程度密切相关  相似文献   

6.
急性颅脑损伤常合并眼外伤 ,由于病情复杂需与脑外科配合尽早处理。我院自 1990~ 2 0 0 1年 4月共收治重型颅脑损伤684例 ,其中合并眼外伤 10 8例 ,占 15 85 %。现报告如下 :(一 )临床资料1 一般情况 :本组资料 10 8例 (10 8眼 ) ,男 73例 ,女 3 5例 ;年龄 5~ 70岁 ,平均 3 7 5岁。额顶眼眶部骨折 3 9眼 ,眼球破裂伤18眼 ,眼内异物 16眼 ,眼眶软组织挫伤 2 0眼 ,眼睑皮肤裂伤 15眼。2 致伤原因 :车祸 11眼 ,火器伤 2 2眼 ,各种打击伤 14眼 ,坠落伤 17眼 ,枪伤 18眼 ,爆炸伤 2 6眼。(二 )处置原则1 中重型颅脑伤合并眼外伤。先由脑外科救…  相似文献   

7.
玩具枪致眼外伤48例分析   总被引:3,自引:2,他引:1  
近年来 ,玩具枪致眼外伤较为常见。 1998年 2月~2 0 0 3年 2月 ,我科共收治玩具枪致眼外伤 4 8例。现报告如下 :1 临床资料1 1 一般资料5年中共收治眼外伤 6 2 7例 ,其中玩具枪致伤 4 8例(48眼 ) ,占眼外伤的 7 6 6 %。年龄以 6~ 15岁最多 ,共 36例 ,占 75 0 0 % (表 1)。  相似文献   

8.
眼—心反射   总被引:5,自引:0,他引:5  
加压眼球或牵张眼组织时,可能引起心率减慢、心率异常,伴有胸闷不适等异常感觉。这一现象,即称眼—心反射(简作OCR)。最早由Aschwer及Dagnini于1908年发现记述。由于眼科手术中所诱发的OCR可引起明显心脏功能改变,甚至停搏死亡,因此,OCR已渐为眼科医生重视。近20年来,已发表资料计有60余篇。对于迷走神经功能检查与眼科手术时加压眼球所引起的OCR,内科与眼科有着不同考虑(Buchnalter 1968)。为测定植物神经功能,内科有时采用OCR试验。方法:指压眼球3~4秒钟后,计算一分钟脉搏数。若眼球压后比压前脉搏减慢10~12次以上者,便为“阳性”结果。表明  相似文献   

9.
患者女 ,3 8岁。因左眼视物模糊伴眼前黑影遮挡 8h ,于2 0 0 4年 5月 2 7日来我院就诊。全身检查 :一般情况正常 ,血压15 0 /10 5mmHg(1mmHg =0 .13 3kPa) ,颈动脉超声多普勒检查未见明显异常。实验室检查 :甘油三酯 192mg/dL ,载脂蛋白 2 .0 1g/L ;全血黏度 5 .47mPa·s ,全血高切黏度 4.3 5 mPa·s ,全血低切黏度 8.64mPa·s。患者否认既往眼病史。否认有糖尿病、多发性血管炎等病。眼科检查 :视力右眼 1.0 ,左眼 0 6。眼压 :右眼 12mmHg ,左眼 11.3 mmHg。右眼内外眼正常。左眼角膜透明 ,前房正常 ,瞳孔直径约 3 .5mm ,直接对光反射…  相似文献   

10.
农民眼外伤495例调查分析   总被引:1,自引:0,他引:1  
目的探讨农民眼外伤临床特点及处理方法。方法将我院近几年收治的495例(515眼)农民眼外伤进行回顾性分析。结果农民眼外伤995例占同期收治的眼外伤病例的72.26%。农民眼外伤最多是植物性伤,占43.03%;车祸伤次之,占13.94%:致伤物主要是农田秸杆、麦芒、谷粒、芦苇等:治疗前视力≤0.05者28眼占5.44%,0.7以上5眼,占0.97%;治疗后视力≤0.05者减至9眼占1.75%;0.7以上增至214眼,占41.55%。结论农民眼外伤严重危害视功能,及时正确处理可获较好疗效。  相似文献   

11.
Purpose: To describe the clinical and pathological features of malignant transformation of an optic nerve melanocytoma over 25 years, associated with spontaneous extensive tumor necrosis, neovascular glaucoma, ocular ischemic syndrome, and oculocardiac reflex. Procedures: A 60-year-old Caucasian female presented with acute severe left ocular pain and glaucoma with an intraocular pressure of 80?mmHg and bradycardia (28–40 beats/min). Results: Histopathological examination of the enucleated eye showed features of malignant transformation of a spontaneously necrotic optic nerve melanocytoma associated with ocular ischemic syndrome and neovascular glaucoma. Conclusions: Yearly follow-up and awareness of possible but well-documented malignant transformation, even over several decades, is recommended. This case presents malignant transformation of an optic nerve melanocytoma associated with the common complications described in the literature over the years. Of particular interest was the development of oculocardiac reflex in this patient.  相似文献   

12.
目的:观察局部麻醉监护情况下成人水平斜视手术中心电图、呼吸、血氧饱和度、血压的变化情况。

方法:临床确诊为水平斜视的17例成人患者19眼36条眼外肌纳入研究。其中男10例,女7例。年龄18~71(平均32.65)岁; 外斜视14例(男8例,女6例),内斜视3例(男2例,女1例)。所有患者均进行最佳矫正视力(BCVA)、裂隙灯显微镜、间接检眼镜、角膜荧光及眼科同视机检查。术中由专业麻醉医师采用监护仪对手术采取全程密切监控。对比分析术前与局部麻醉监护术中的心电图、呼吸频率、血氧饱和度及血压的变化情况,对比内外直肌、不同性别及不同年龄组的区别。

结果:局部麻醉监护下17例成人水平斜视手术中牵拉眼外肌共36条,眼心反射发生率86.1%; 牵拉内、外直肌,眼心反射阳性率分别为100%,72.2%。眼心反射在男女性别间无统计学差异。18~30岁眼心反射阳性率明显高于31~71岁。术中呼吸频率的增高与眼心反射同步,与牵拉内外直肌、性别及不同年龄组无关。血氧饱和度无明显变化。血压在手术刚开始时出现一过性增高,首次牵拉眼内外直肌时出现一过性降低,在性别和年龄上无明显差异。

结论:在局部麻醉监护下成人水平斜视手术中,眼心反射发生率高,牵拉内直肌时100%发生; 呼吸增快与眼心反射同步; 手术即将开始时血压增高、牵拉眼内外直肌时血压降低。  相似文献   


13.
The oculocardiac reflex was quantitatively studied in 15 patients with strabismus. The reflex was observed in all patients when the medial rectus and inferior oblique muscles were stretched; the medial rectus muscle had a lower threshold than the inferior oblique. Bradycardia was evoked in 7 of the 15 patients when the lateral rectus was tractioned with tensions of 50 g and 600 g. The oculocardiac reflex was a graded phenomenon as a function of tension applied to the extraocular muscles. As tension was increased, bradycardia occurred rapidly and became deep. Systemic administration of atropine prevented completely the bradycardia from occurring. The results suggest that the response of the extraocular muscles to stretch are critically mediated through a polysynaptic path to the heart, resulting in suppression of the heart rate.  相似文献   

14.
Vagal responses to adjustable sutures in strabismus correction.   总被引:2,自引:0,他引:2  
The oculocardiac reflex is a recognized complication of ocular stimulation, precipitated most commonly by traction on the extraocular muscles. To determine the true incidence of occurrence of the oculocardiac reflex during suture adjustments, 20 patients undergoing suture adjustment were monitored for blood pressure, heart rate, and rhythm abnormalities during the suture adjustment. A control group of ten patients with strabismus were studied postoperatively for comparison. Thirteen study patients and two control patients were noted to have a vagal response (P less than .001). The most common response noted was a decrease in heart rate in 15 patients. Only two patients were symptomatic during vagal response (one patient became light-headed and another had an episode of nausea and vomiting). Suture adjustment was found to be the most common triggering event in precipitating vagal responses. Surgeons performing suture adjustment in strabismus correction should be cognizant of vagal responses so that they may properly inform patients of this possibility and take steps to minimize its occurrence.  相似文献   

15.
赵娟 《眼科研究》2011,29(7):669-672
眼心反射(OCR)在眼科手术中的发生率高达90%,而大多数临床医师认为OCR的表现仅仅是心动过缓、心律失常,却忽略了其他系统的表现,如:“眼肺反射”(ORR)、“眼胃反射”,也有人称之为“眼一呕吐反射(OER)”等。OCR并非仅仅为眼科手术的并发症,其在窦房结内镜手术过程中和治疗进行性三叉神经痛的过程中也可发生,但对此现象的描述以临床表现报道居多。目前的研究有助于提高临床医师对OCR的认识,对OCR的眼胚胎、解剖、生理、电生理、发生机制等研究进展进行综述,提出应重新认识OCR的本质特征,认为其名称为眼迷走神经反射(OVR)更为合理。  相似文献   

16.
Electrocardiographic changes during subconjunctival injections   总被引:1,自引:0,他引:1  
Electrocardiographic changes were investigated in 53 patients duringsubconjunctival drug injections. Decrease in heart-rate of more than10% or arrhythmia was observed in 25 (47.2%) of the patients, whowere considered to have a positive oculocardiac reflex. In the control group of 35 patients, only 3 (8.6%) were found to have a significant decrease in heart rate during blood sampling from antecubital vein (p = 0.000). Young age was a significant risk factor for oculocardiac reflex during injections (p = 0.01). Patient gender, verbal pain score, satiety, experience of periocular injections, injected drug type were not found to be risk factors. All patients with oculocardiac reflex were asymptomatic; however, it is still wise to have emergency supplies readyfor any circulatory derangement during subconjunctival injections.  相似文献   

17.
高翔  秦学斌  郭军 《国际眼科杂志》2011,11(8):1466-1468
目的:观察不同麻醉方法下视网膜脱离外路手术中的眼心反射。方法:选取我科2008-06/2010-03住院患者109例109眼,随机分为对照组和治疗组,分别采用球后阻滞麻醉与静脉复合麻醉进行视网膜脱离外路手术,观察术中血压、心率、眼心反射、血氧饱和度等情况。结果:与球后阻滞麻醉比较,静脉复合麻醉下眼心反射发生率低,收缩压、舒张压及平均血氧饱和度变化较小,经统计学处理,差异有统计学意义(P<0.01)。结论:静脉复合麻醉下行视网膜脱离外路手术相对安全,并发症少,效果满意。  相似文献   

18.
A healthy 21-year-old man had laser in situ keratomileusis (LASIK) in the right eye for a refractive error of -7.0 diopters. The electrocardiogram findings and heart rate were recorded before LASIK; during eye lid speculum insertion, vacuum application, corneal flap preparation, and excimer laser keratectomy; and after the procedure. The pre-LASIK heart rate was 90 pulses/min. Severe bradycardia of 40 beats/min developed during vacuum application, and the procedure was terminated. Severe bradycardia caused by an oculocardiac reflex may occur during LASIK, and patients should be closely monitored during the procedure.  相似文献   

19.
In the study reported here the authors investigated the influence on ocular perfusion pressures of suction-cup oculopression, a procedure which permits oculopression without orbital compression. Patients over 50 years of age were examined before cataract extraction. Ulrich's method of ocular oscillodynamography was used to determine ocular perfusion pressures. A Mikuni and Yoneyama suction-cup dynamometer was applied for suction-cup oculopression. Ocular hypotonia following suction-cup oculopression was adequate and comparable to that achieved by other oculopression methods. After oculopression a significant increase in ocular perfusion pressures (retinal, ciliary, and diastolic) was found. However, ocular blood pressure remains constant after oculopression. Moreover, the increase in ocular perfusion pressure could not be explained by oculocardiac reflexes, because there was no change in systemic arterial blood pressure. It must be assumed, therefore, that the increase in ocular perfusion pressures is caused by a lowering of resistance, i.e., a drop in intraocular pressure.  相似文献   

20.
Purpose: The aim of this study was to evaluate whether orbital changes induced by thyroid eye disease affect the ocular pulse amplitude and choroidal perfusion.

Materials and Methods: A total of 38 eyes of 38 patients with thyroid eye disease (Group 1) and 38 eyes of 38 control individuals (Group 2) with normal intraocular pressure were enrolled in this study. Thyroid eye disease activity was defined using clinical activity score. Intraocular pressure measurement with Goldmann applanation tonometer, axial length, central corneal thickness, Hertel exophthalmometry and systolic and diastolic blood pressure measurements were taken from each patient. Ocular pulse amplitude and intraocular pressure were measured using dynamic contour tonometry. Choroidal thickness was measured by enhanced depth imaging-optical coherence tomography at subfoveal, nasal and temporal 1000 μm area.

Results: Intraocular pressures measured with Goldmann applanation tonometer and dynamic contour tonometry and mean ocular pulse amplitude were not statistically different between groups. However mean choroidal thicknesses were significantly lower when compared to control group. Ocular pulse amplitude and intraocular pressure measurement with dynamic contour tonometry did not change significantly with the increase in clinical activity score. There was not statistically significant correlation between ocular pulse amplitude and choroidal thicknesses in patients with thyroid eye disease.

Conclusion: Ocular pulse amplitude and choroidal perfusion were not found to change with orbital involvement in thyroid eye disease and with disease activity, especially in patients with normal intraocular pressure. Although choroidal thickness was thinner than control group, choroidal perfusion did not change as a compensatory mechanism for maintaining ocular homeostasis.  相似文献   

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