化学性眼外伤16例急救与护理

为探讨化学性眼外伤患者的综合治疗效果及护理方法,对16例(20眼)化学性眼外伤患者进行入院急救处理、心理护理、眼部护理、并发症预防及护理等.结果本组Ⅰ度烧伤患者视力全部恢复0.8以上;Ⅱ度烧伤视力恢复0.3～0.4 3眼,0.5～0.6 2眼;Ⅲ度烧伤视力恢复0.1～0.2 5眼,0.2～0.3 2眼;Ⅳ度烧伤视力恢复0.05 1眼,有光感者4眼.认为专科护士熟悉和掌握化学性眼外伤的紧急救治、实施有效的护理,有利于减少并发症发生,对提高疗效、挽救视力、降低致盲致残率具有积极作用.     

化学性眼外伤16例急救与护理

为探讨化学性眼外伤患者的综合治疗效果及护理方法,对16例（20眼）化学性眼外伤患者进行入院急救处理、心理护理、眼部护理、并发症预防及护理等。结果本组Ⅰ度烧伤患者视力全部恢复0.8以上;Ⅱ度烧伤视力恢复0.3～0.4 3眼,0.5～0.6 2眼;Ⅲ度烧伤视力恢复0.1～0.2 5眼,0.2～0.3 2眼;Ⅳ度烧伤视力恢复0.05 1眼,有光感者4眼。认为专科护士熟悉和掌握化学性眼外伤的紧急救治、实施有效的护理,有利于减少并发症发生,对提高疗效、挽救视力、降低致盲致残率具有积极作用。     

基层医院眼外伤的常见病因分析和治疗体会

目的探讨基层医院眼外伤发生的病因及处理预防措施。方法对句容市中医院诊治的300例(340眼)眼外伤患者的临床资料进行回顾性分析。结果 300例眼外伤患者中异物致伤发生率最高(41%),其次为钝挫伤(18%),再次为化学伤、热烧伤、辐射伤及爆炸伤。治疗以急诊手术、药物及对症治疗为主。无光感14眼的患者中7眼转院,视力恢复不明,5眼治疗后视力为指数-0.1,2眼维持原来视力;光感-手动者26眼中转院10眼,治疗16眼,治疗后视力为指数-0.1者8眼,0.1～0.3者3眼,5眼维持原来视力;指数-0.1的102眼中转院5眼,治疗后0.1～0.3者56眼,维持原来视力41眼;0.1～0.3者32眼治疗后>0.3者26眼,维持原来视力6眼;>0.3者166眼治疗后除2眼转院外,其他患者经治疗后视力均未下降。结论眼外伤严重危害视功能,伤后须及时正确处理;为避免不可挽回的视力损害,预防更为重要。     

儿童眼外伤138例临床分析

目的:分析儿童眼外伤临床特点、处理方法及预防。方法:对10年来收治的138例儿童眼外伤进行临床分析。结果:儿童眼外伤常见致伤物:玩具枪、鞭炮烟花、棍棒、刀剪、化学物等。致盲最多是穿孔伤,钝挫伤次之。治疗前盲目者58眼(42.02%),治疗后盲目者16眼(11.59%),视力恢复>0.7者59眼(42.75%)。眼球穿孔伤79眼,视力恢复≥0.30者31眼(39.24%)。结论:儿童眼外伤严重危害视功能,致盲率较高,因此儿童眼外伤重在预防,伤后及时正确处理可获较好疗效。     

木柴相关性眼外伤32例临床分析

目的:总结木柴相关性眼外伤的临床特点,为防治其提供帮助。方法:回顾性分析富平县医院眼科2017年3月至2018年3月诊治的木柴相关性眼外伤32例患者的临床资料。结果:32例均为单眼受伤,其中男性22例,女性10例,受伤年龄20-60岁;受教育程度多为初中及以下;受伤原因多与从事农业生产、生活劈柴有关(31例)。患者多因受伤后视力下降、眼红、眼痛、流血等原因就诊;就诊时间长短不一,其中伤后8 h内就诊13例,8-24h内就诊14例,1-7 d内就诊3例,超过1月就诊2例。眼部表现因致伤物的大小、方向、速度而异,以眼挫伤为主,严重者可发生眼球穿通伤、眼球破裂伤、眶内异物、继发性青光眼等。按机械性眼外伤急诊治疗原则,选择合适的治疗手段。患者视力恢复情况与眼外伤轻重程度、累及范围、就诊时间及依从性有关。结论:木柴相关性眼外伤以男性青壮年居多,多为单眼受伤,职业多以农业为主,受伤程度轻重不等,覆盖所有机械性眼外伤改变。视力预后与受伤程度以及是否及时诊治相关,加强宣传和职业防护对本病的预防非常重要。     

268例急性炎性眼表疾病的治疗分析

目的：对初诊急性炎性眼表疾病268例326眼的治疗结果进行分析。方法；根据268例326眼急性炎性眼表疾病的临床表现及性质的不同局部或全身及时给予抗菌消炎、抗病毒等相关的治疗。结果：268例326眼急性炎性眼表疾病经及时治疗，患者的眼部及全身症状分别在1周至2周内或1个月内好转，视力恢复，病情得以治愈，无一例严重并发症出现，治愈率为100。结论：268例326眼初诊急性炎性眼表疾病的及时治愈．对有效减少角膜缘干细胞的损害，防止角膜混浊、角膜穿孔等损害视力的严重并发症具有一定的临床意义。     

影响眼外伤视力预后危险因素的Logistic回归分析

眼外伤后的病人多伴有视力降低,甚至有失明的危险[1]。然而伤后成功的急救治疗可以有效地避免失明。本文旨在探讨眼外伤发生后影响视力预后的危险因素,使病人、医护人员在急救中做到有的放矢。1资料与方法1.1临床资料我院1994年8月—2002年6月共收治眼外伤病人674例,伤眼718眼,其中右眼341眼,左眼377眼,右眼与左眼之比为1∶1.11,双眼同时受伤者44例,占眼外伤病人的6.53%。其中男513例,女161例,男女之比为3.19∶1;年龄1岁～72岁,平均24.45岁。外伤分类按国际疾病分类(ICD-9)中损伤和中毒外部原因分类:眼及附属器挫伤193眼,占26.88%;眼球开…     

沧州市眼外伤调查分析

目的 探讨眼外伤的发生规律及救治特点.方法 对来我院诊治的住院679例患者进行性别、年龄、受伤眼别、就诊时间、致伤原因、致伤性质、全身其他部位外伤及视力等项目进行统计分析.结果 主要致伤原因为拳击伤共238例(35.05%).眼外伤性质主要为眼挫伤共370例(54.49%).其中231例(34.02%)有全身其他部位外伤,以颌面部、头颅四肢伤居多.结论 眼外伤发病率高,伴全身其他外伤者多,发生原因多.     

城市儿童急诊眼外伤15年133例回顾性研究

目的了解城市儿童急诊眼外伤临床特点及视力恢复情况。方法回顾性分析福建省立医院眼科1999年1月至2014年1月收治的16岁及以下急诊眼外伤患儿的基本资料、致伤原因、外伤类型、治疗措施与最近随访最佳矫正视力。结果 133例136眼纳入本研究。男性患儿比例显著高于女性患儿(2.7:1);多数患儿年龄范围为0~5岁(41.4%);最主要致伤原因为剪刀等锐器(47.8%);开放性眼外伤显著多于闭合性眼外伤(72.1%v.s.19.9%);96例(70.6%)患儿急诊行角巩膜裂伤缝合术;68眼(50.0%)视力预后不良,其中开放性眼外伤占62例(91.2%)。结论城市儿童眼外伤以锐器引起的开放性眼外伤为主,大多患儿视力预后不良。家庭一级预防与学校宣教对预防严重儿童眼外伤具有重要意义。     

眼挫伤30例临床特点分析

眼挫伤是机械性眼外伤中发病率较高,损伤性质较复杂的疾病,眼部组织对暴力打击承受能力都比较低,受挫伤后往往造成多部位的组织损伤,由于伤情复杂,为防止疏忽遗漏,在进行诊断处理时,必须非常谨慎细致,以便不失时机地进行治疗。现将我们1989～1990年间治疗的69例各种眼外伤中眼挫伤患者30例,根据临床特点分析如下: 一、一般资料本组30例中,受伤眼数34眼。其中男24例,女6例。年龄18～65岁,平均年龄为41.5岁,均经详细询问病史,系统的检查视力、视野、眼压、眼睑、眼前部与眼底、眼眶及眼附属器,也检查     

Injury to the head and face in patients with cervical spine injury

The charts of 81 patients with acute cervical spine fracture and/or subluxation were reviewed to determine the incidence of injury to the soft tissue and bone of the head or face in these patients. Motor vehicle accidents accounted for over 69% of these injuries. Only 33 patients had concomitant soft tissue injury to the head or face, and only five had facial and/or skull fractures. Injuries of the skull and face do not usually accompany cervical fractures, and our findings do not support the restriction of post-traumatic cervical spine radiography in the emergency department to patients with obvious head or facial trauma.     

Identification of Intra-abdominal Injuries in Children Hospitalized Following Blunt Torso Trauma

OBJECTIVE: To determine the utility of the ED physical examination and laboratory analysis in screening hospitalized pediatric blunt trauma patients for intra-abdominal injuries (IAIs). METHODS: The authors reviewed the records of all patients aged <15 years who sustained blunt traumatic injury and were admitted to a Level 1 trauma center over a four-year period. Patients were considered high-risk for IAI if they had any of the following at ED presentation: decreased level of consciousness (GCS < 15), abdominal pain, tenderness on abdominal examination, or gross hematuria. Patients without any of these findings were considered moderate risk for LAI. The authors compared moderate-risk patients with and without IAIs with regard to physical examination and laboratory findings obtained in the ED. RESULTS: Of 1,040 children with blunt trauma, 559 (54%) were high-risk and 481 (46%) were moderate-risk for IAI. 126 (23%) of the high-risk and 22 (4.6%) of the moderate-risk patients had IAIs. Among moderate-risk patients with and without IAIs, those with IAIs were more likely to have abdominal abrasions (5/22 vs 34/459, p = 0.008), an abnormal chest examination (11/22 vs 86/457, p = 0.01), higher mean serum concentrations of aspartate aminotransferase (AST) (604 U/L vs 77 U/L, p < 0.001) and alanine aminotransferase (ALT) (276 U/L vs 39 U/L, p = 0.002), higher mean white blood cell (WBC) counts (16.3 K/mm3 vs 12.8 K/mm3, p < 0.001), and a higher prevalence of >5 RBCs/hpf on urinalysis (7/22 vs 54/427, p = 0.02). There was no significant difference (p > 0.05) between moderate-risk patients with and without IAIs in initial serum concentrations of amylase, initial hematocrit, drop in hematocrit >5 percentage points in the ED, or initial serum bicarbonate concentrations. CONCLUSION: In children hospitalized for blunt torso trauma who are at moderate risk for IAI, ED findings of abdominal abrasions, an abnormal chest examination, and microscopic hematuria as well as elevated levels of AST and ALT, and elevated WBC count are associated with IAI.     

Chronic post-traumatic neck and head pain

OBJECTIVE: This is a review of current concepts of chronic post-traumatic neck and head pain. In this article, I will emphasize the physiological and sociological aspects of these disorders. BACKGROUND: The pathophysiology of chronic post-traumatic neck and head pain has not been well understood. Some have emphasized the organic factors and others the psychogenic aspects of these conditions. Only in recent years have this dichotomy been integrated with sociocultural concepts. METHODS: The history of chronic post-traumatic head and neck pain is reviewed. Paradoxes are discussed, ie, the great differences in prevalence around the world, the inconsistent relationship of symptoms to degree of trauma, the curious phenomena of structural disease without symptoms, and symptoms without structural disease. The organic and pathophysiologic factors are reviewed, then those factors that modulate pain in these conditions are discussed. CONCLUSION: Chronic post-traumatic neck and head pain is rarely either organic or psychogenic. Rather physiological, social, and cultural factors play major roles in modulating pain and either perpetuate or ameliorate these chronic pain conditions.     

Myocardial contusion in blunt chest trauma: A ten-year review

A retrospective review was undertaken of 169 patients admitted to an Intensive Therapy Unit with a major chest injury to determine the incidence, clinical features and outcome of patients with myocardial contusion. This injury occurred in 29 (17%) patients, of whom 24 (83%) had significant cardiovascular complications and five died as a direct result of the injury. The interval between injury and diagnosis was 3.2±2.3 days (mean±SD) from injury and in six patients the diagnosis was made only at necropsy. Increased awarenness of myocardial contusion is required for earlier diagnosis and prevention of complications.     

预制破片致兔胸部爆炸伤的实验研究

目的：研究预制破片铝制雷管致兔胸部爆炸伤的伤情特点及规律，为制定胸部爆炸伤的救治原则提供实验依据。方法：用电启动方式引爆预制破片铝制雷管，将32只家兔置于距雷管5，8，10，12，15cm处，致伤前后常规观察生命体征及破片，冲击波对胸壁，肺脏和周围组织脏器的损伤情况，结果：伤后即刻死亡率为46．9％，各组死亡率有明显差异，冲击波主要靶器官为肺脏，破片伤发生率为62．5％，以盲管伤为主，常合并肋骨折及肋间血管损伤，心肌挫伤，肝脾，胃肠破裂。结论：胸部爆炸伤伤情复杂，死亡率高，伤后易致以肺功能衰竭（ARDS）为主的多脏器功能衰竭，破片伤致失血性休克和冲击伤致急性肺功能损伤是伤后早期死亡的主要原因。     

不同时相下颌面部破片+冲击波复合伤特点研究

目的　研究爆炸破片及冲击波在不同时相下作用于颌面部时的损伤特点并探讨其致伤机制。方法　利用颌面部高速破片 冲击波复合致伤模型模拟爆炸伤 ,由同步系统控制不同致伤时相。按不同时相将重庆当地成年犬 15只随机分为 3组 ,A组为破片先与冲击波到达目标 ,B组为二者同时到达 ,C组为冲击波先于破片到达。破片对犬咬肌区致伤 ,记录致伤参数 ,观察动物伤情特点。结果　在其它致伤条件相同时 ,B组致伤冲击波为双波峰形态。致伤后A组颌面部皮肤与肌肉分离明显 ,污染严重 ,创面最大 ,B组次之 ,C组最小。B组局部组织坏死及挫伤范围均较其它两组明显 ,并有心、肺、脑等脏器的损伤。结论　颌面部爆炸伤伤情严重 ,高速破片与冲击波具有协同致伤作用 ,不同组织对冲击波的反应不同是局部伤情不同的原因     

The Effect of Concussion History on Lower Extremity Injury Risk in College Athletes: A Systematic Review and Meta-Analysis

IntroductionCollegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.ObjectiveTo conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.MethodsA literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, [“concussion” OR “brain injury” OR “mild traumatic brain injury” OR “mTBI”] AND [“lower extremity injury” OR “musculoskeletal injury”]. Articles were included if they were published between January 2000 and July 2021 and examined collegiate athletes’ risk of sustaining a lower extremity musculoskeletal injury following a concussion. Methodological quality of included studies was performed with a modified Downs and Black Checklist. The primary outcome of interest was the risk of sustaining a lower extremity musculoskeletal injury following a concussion. A random effects meta-analysis was conducted in which a summative relative risk (RR) for sustaining a lower extremity injury in athletes with and without a history of concussion was calculated.ResultsSeven studies met the eligibility criteria to be included in the systematic review. There were 348 athletes in the concussion group and 482 control athletes in the included studies. Most of the studies were of good or excellent quality. Five of the seven studies were able to be included in the meta-analysis. College athletes who suffered a concussion possessed a 58% greater risk of sustaining a lower extremity musculoskeletal injury than those who did not have a history of a concussion (RR = 1.58[1.30, 1.93]).ConclusionsLower extremity injury risk is potentially increased in college athletes following a concussion compared to those without a history of a concussion. Further research is needed to investigate the mechanism behind this increased risk. Clinical assessments throughout the concussion return-to-play protocol may need to be improved in order to detect lingering impairments caused by concussions.Level of Evidence1