儿童眼外伤2 298例的回顾性分析

目的:对2016~2020年在湖南省儿童医院眼科就诊的眼外伤患儿的病例资料进行分析总结,为儿童眼外伤的预防和治疗提供理论依据。方法:回顾性分析2016-01/2020-12在湖南省儿童医院眼科门急诊及住院治疗的眼外伤患儿2298例2332眼的临床资料,对患儿性别、年龄、受伤眼别、就诊时间、致伤月份、致伤原因、受伤部位、眼外伤类型、并发症、治疗方法和视力进行分析。结果:眼外伤患儿年龄主要集中在>3~6岁,占患儿总数的44.26%,其中男1718例1745眼,女580例587眼,男女比例为2.96∶1.00。2月份和11月份是儿童眼外伤的高发期。撞伤和摔伤是其主要的致病原因,占40.95%;其次为钝物击伤及锐器伤,共占40.82%。眼外伤患儿受伤部位主要在眼睑等眼附属器,占65.40%。患儿受伤后采取清创、包眼或局部点眼药等保守治疗方式占58.62%,行清创缝合术患儿占38.38%,复杂性眼内手术占3.00%。大多数患儿难以配合检查视力,在完成视力检查的患儿中,眼外伤影响患儿视力者占60.60%,治疗后患儿视力均有不同程度的好转。严重影响视力主要集中在角膜挫裂伤、外伤性白内障、玻璃体积血、球内异物及眼球破裂等患儿。结论:儿童眼外伤较常见,多为意外伤害,近年来有上升趋势。眼外伤患儿以男性、学龄前儿童为主,绝大多数患儿病情相对较轻,视力预后良好。儿童眼外伤重在预防,受伤后及时就诊能有效降低外伤对视力的损害。

Retrospective analysis of 2 298 children with ocular trauma

AIM: To characterize a large cohort of patients presenting to the Department of Ophthalmology in Hunan Children''s Hospital for ocular trauma, thus to offer supports for treatment and prevention of ocular trauma in children.

METHODS:The retrospective study was conducted between January 2016 and December 2020, and the medical recorded of 2 298 children(2 332 eyes)diagnosed with ocular trauma in the Ophthalmology Department and Ophthalmic Emergency of Hunan Children''s Hospital were reviewed. The record data included gender, age, wounded eye, time of day, injury month, cause of injury, zone of injury, types of ocular injury, complications, method of treatment and prognosis of visual acuity.

RESULTS: The results showed that 44.26% of ocular trauma occurred in the age of 3-6 years old in children, and 1 718 cases(1 745 eyes)in male children versus 580 cases(587 eyes)in female children, with a male to female ratio of 2.96:1.00. The high incidence months were February and November for pediatric ocular injury. Collisions and falls were the main causes, accounting for 40.95%, following with blunt object injury and sharp object injury, accounting for 40.82%. Eyelid and other accessory organs were the main injury sites(65.40%). After injury, 58.62% of the children were treated with debridement, primary closure or topical administration of eye drops, 38.38% were treated with debridement and suturing, and 3.00% were treated with complex intraocular surgery. Most children patients were difficult to cooperate with the vision examination. Among the children who completed the vision examination, 60.60% showed visual impaired due to eye trauma. And after treatment, their vision improved to varying degrees. The severe impairment of visual acuity was mainly caused by corneal contusion, traumatic cataract, vitreous hemorrhage, bulbar foreign body and rupture of eyeball.

CONCLUSION: Pediatric ocular injuries are usually accidental, with an increasing incidence in recent years. The majority of children with ocular trauma are male and preschool children, with generally mild injuries and relatively good visual prognosis. Prevention and education on children''s ocular traumas should be emphasized, and timely treatments after injury can effectively reduce the visual damage.