山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (2): 26-33.doi: 10.6040/j.issn.1673-3770.0.2023.085

• 论著 • 上一篇    下一篇

4 526例开放性眼外伤流行病学特点及预后因素影响分析

付庆毓,刘添添,王平平,刘陇黔   

  1. 四川大学华西医院 眼科, 四川 成都 610041
  • 出版日期:2024-03-20 发布日期:2024-03-29
  • 通讯作者: 刘陇黔. E-mail:b.q15651@hotmail.com
  • 作者简介:付庆毓、刘添添为共同第一作者

Epidemiological characteristics and prognostic factors associated with 4 526 cases of open globe injuries: a retrospective study

FU Qingyu, LIU Tiantian, WANG Pingping, LIU Longqian   

  1. Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
  • Online:2024-03-20 Published:2024-03-29

摘要: 目的 探讨开放性眼外伤(open globe injury, OGI)流行病学特点和预后影响因素。 方法 对四川大学华西医院2009年1月至2020年12月间4 526例OGI患者进行回顾性研究,对患者的一般情况、致伤原因、并发症、受伤后就诊时间等因素对出院视力的影响进行单因素分析,对差异具有统计学意义的单因素进一步采用多因素二元Logistic回归模型进行分析。 结果 多因素二元Logistic回归分析显示,少数民族、(45,60)岁、(60,75)岁、钝物致伤、摔倒致伤、再次入院、住院时间延长、合并球内出血、晶状体脱位和眶骨骨折是出院视力<0.05的危险因素(OR=1.355,1.380,2.387,1.716,1.601, 2.013,1.889,1.983,1.857,3.311;95%CI=1.050~1.748,1.140~1.670,1.632~3.490,1.290~2.282,1.066~2.403,1.668~2.429,1.581~2.258,1.627~2.417,1.351~2.553,2.109~5.198;P均<0.05)。 结论 OGI以中青年男性为主,致伤因素多与工作场所相关,视力预后差,应开展具有针对的预防干预措施。

关键词: 开放性眼外伤, 眼球破裂伤, 机械性眼外伤, 球内出血, 晶状体脱位, 眶骨骨折

Abstract: Objective To study the epidemiological features and prognostic factors of open globe injuries(OGI). Methods A retrospective study was conducted, focusing on OGI treated at West China Hospital, Sichuan University, between January 2009 and December 2020. Univariate analysis was used to determine the impact of various factors, including general patient information, causes of injury, complications, and the interval between injury and presentation to the hospital, on the visual outcomes at discharge. Factors that showed statistically significant differences were further analyzed using a multivariate binary Logistic regression model. Results Multivariate binary Logistic regression analysis revealed that, ethnic minorities, age groups of(45, 60)years, age groups of(60, 75)years, blunt object resulting in injury, falls resulting in injury, rehospitalization, prolonged hospital stay, complications included intraocular hemorrhage, dislocated lens, and orbital fractures are risk factors for discharge visual acuity <0.05(OR=1.355, 1.380, 2.387, 1.716, 1.601, 2.013, 1.889, 1.983, 1.857, 3.311; 95%CI=1.050-1.748, 1.140-1.670, 1.632-3.490, 1.290-2.282, 1.066-2.403, 1.668-2.429, 1.581-2.258, 1.627-2.417, 1.351-2.553, 2.109-5.198; all P<0.05). Conclusion OGI predominantly affect young and middle-aged males, with many injuries related to the workplace. Visual prognosis of OGI is generally poor, emphasizing the need for targeted preventive interventions.

Key words: Open globe injury, Ocular rupture injury, Mechanical eye injury, Intraocular hemorrhage, Dislocated lens, Orbital fractures

中图分类号: 

  • R779.1
[1] Iftikhar M, Latif A, Farid UZ, et al. Changes in the incidence of eye trauma hospitalizations in the United States from 2001 through 2014[J]. JAMA Ophthalmol, 2019, 137(1): 48-56. doi:10.1001/jamaophthalmol.2018.4685
[2] Mir TA, Canner JK, Zafar S, et al. Characteristics of open globe injuries in the United States from 2006 to 2014[J]. JAMA Ophthalmol, 2020, 138(3): 268-275. doi:10.1001/jamaophthalmol.2019.5823
[3] Heath Jeffery RC, Dobes J, Chen FK. Eye injuries: understanding ocular trauma[J]. Aust J Gen Pract, 2022, 51(7): 476-482. doi:10.31128/AJGP-03-21-5921
[4] 贺翔鸽. 机械性眼创伤的定义、分类和伤情判别[J]. 中华创伤杂志, 2001, 17(4): 251-252. doi: 10.3760/j: issn: 1001-8050.2001.04.026 HE Xiangge. Definition, classification and injury discrimination of mechanical eye trauma[J]. Chinese Journal of Traumatology, 2001, 17(4): 251-252. doi: 10.3760/j: issn: 1001-8050.2001.04.026
[5] 刘成刚, 陈丽鸿. 春节眼外伤临床特征和伤情预后分析[J]. 国际眼科杂志, 2018, 18(11): 2046-2050 LIU Chenggang, CHEN Lihong. Clinical features and prognosis of ocular injuries during Spring Festival[J]. International Eye Science, 2018, 18(11): 2046-2050
[6] 仝彤, 贺广秀, 李素华. 眼外伤患者创伤后应激障碍症状特征及社会心理因素[J]. 中国健康心理学杂志, 2021, 29(7): 996-1001. doi: 10.13342/j.cnki.cjhp.2021.07.009 TONG Tong, HE Guangxiu, LI Suhua. Symptom characteristics of post-traumatic stress disorder in patients with ocular trauma and analysis of social-psychosocial factors[J]. China Journal of Health Psychology, 2021, 29(7): 996-1001. doi: 10.13342/j.cnki.cjhp.2021.07.009
[7] Kyriakaki EDO, Detorakis ET, Bertsias AK, et al. Ocular trauma, visual acuity related to time of referral and psychosocial determinants, during COVID19 pandemic: a prospective study[J]. Exp Ther Med, 2023, 25(3): 130. doi:10.3892/etm.2023.11829
[8] Heindl LM, Trester M, Guo YW, et al. Anxiety and depression in patients wearing prosthetic eyes[J]. Graefes Arch Clin Exp Ophthalmol, 2021, 259(2): 495-503. doi:10.1007/s00417-020-04908-0
[9] Sahraravand A, Haavisto AK, Leivo T. Resource use and economic burden of eye injuries in Southern Finland[J]. Graefes Arch Clin Exp Ophthalmol, 2022, 260(2): 637-643. doi:10.1007/s00417-021-05399-3
[10] 邓美玉, 赵慧. 2011—2020年天津市眼科医院机械性开放性眼外伤调查研究[J]. 医学信息, 2022, 35(19): 118-120. doi: 10.3969/j.issn.1006-1959.2022.19.033 DENG Meiyu, ZHAO Hui. Investigation of mechanical open ocular trauma in Tianjin eye hospital from 2011 to 2020[J]. Medical Information, 2022, 35(19): 118-120. doi: 10.3969/j.issn.1006-1959.2022.19.033
[11] Peleja MB, da Cunha FBS, Peleja MB, et al. Epidemiology and prognosis factors in open globe injuries in the Federal District of Brazil[J]. BMC Ophthalmol, 2022, 22(1): 111. doi:10.1186/s12886-021-02183-z
[12] 邓瑾, 孙文涛, 宋虎平, 等. 机械性开放性眼外伤532例调查研究[J]. 陕西医学杂志, 2019, 48(5): 671-674. doi:10.3969/j.issn.1000-7377.2019.05.036 DENG Jin, SUN Wentao, SONG Huping, et al. The analysis of clinical characteristics of patients with open globe injury in one year[J]. Shaanxi Medical Journal, 2019, 48(5): 671-674. doi:10.3969/j.issn.1000-7377.2019.05.036
[13] Halawa O, Mitchell W, Zebardast N. Fall-related eye injury among older adults in the United States[J]. Am J Ophthalmol, 2021, 229: 82-89. doi:10.1016/j.ajo.2021.03.063
[14] Clynes MA, Harvey NC, Curtis EM, et al. The epidemiology of osteoporosis[J]. Br Med Bull, 2020, 133(1): 105-117. doi:10.1093/bmb/ldaa005
[15] Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis[J]. Osteoarthr Cartil, 2022, 30(2): 184-195. doi:10.1016/j.joca.2021.04.020
[16] Clemson L, Stark S, Pighills AC, et al. Environmental interventions for preventing falls in older people living in the community[J]. Cochrane Database Syst Rev, 2023, 3(3): CD013258. doi:10.1002/14651858.CD013258.pub2
[17] Choovuthayakorn J, Chokesuwattanaskul S, Upaphong P, et al. Globe rupture: a single-center retrospective study of demographic patterns and outcomes[J]. Sci Rep, 2020, 10(1): 19139. doi:10.1038/s41598-020-76121-2
[18] Usmani B, Latif A, Iftikhar M, et al. Eye trauma in falls presenting to the emergency department from 2006 through 2015[J]. Br J Ophthalmol, 2021, 105(2): 198-204. doi:10.1136/bjophthalmol-2019-314669
[19] Chen A, Canner JK, Zafar S, et al. Characteristics of ophthalmic trauma in fall-related hospitalizations in the United States from 2000 to 2017[J]. Ophthalmic Epidemiol, 2022, 29(2): 206-215. doi:10.1080/09286586.2021.1914668
[20] 操文莉, 陈震, 邢怡桥. 1 587例机械性眼外伤流行病学特点及预后影响因素分析[J]. 实用预防医学, 2021, 28(10): 1201-1204. doi:10.3969/j.issn.1006-3110.2021.10.013 CAO Weili, CHEN Zhen, XING Yiqiao. Epidemiological characteristics and prognostic influencing factors of 1 587 cases of mechanical ocular trauma[J]. Practical Preventive Medicine, 2021, 28(10): 1201-1204. doi:10.3969/j.issn.1006-3110.2021.10.013
[21] 林树燕, 吴志群, 吴庆伟, 等. 195例眼外伤住院患者的受伤原因和临床分析[J]. 伤害医学(电子版), 2021, 10(3): 11-14. doi:10.3868/j.issn.2095-1566.2021.03.003 LIN Shuyan, WU Zhiqun, WU Qingwei, et al. Causes of injury and clinical analysis of 195 patients with ocular trauma[J]. Injury Medicine(Electronic Edition), 2021, 10(3): 11-14. doi:10.3868/j.issn.2095-1566.2021.03.003
[22] Chen HL, Han JJ, Zhang XL, et al. Clinical analysis of adult severe open-globe injuries in central China[J]. Front Med(Lausanne), 2021, 8: 755158. doi:10.3389/fmed.2021.755158
[23] 孙振蕊, 蒋晨, 丁琳. 新疆地区开放性眼外伤238例临床分析[J]. 中华眼外伤职业眼病杂志, 2018, 40(3): 191-194. doi:10.3760/cma.j.issn.2095-1477.2018.03.008
[24] 张芳,孟新丹,李军,等. 石河子地区儿童眼外伤的致伤原因和致盲因素分析 [J]. 国际眼科杂志, 2019, 19(4):636-640. doi:10.3980/j.issn.1672-5123.2019.4.24 ZHANG Fang, MENG Xindan, LI Jun, et al. A study on the causes of injury and blindness in children with ocular trauma in Shihezi Area[J]. International Eye Science, 2019, 19(4): 636-640. doi:10.3980/j.issn.1672-5123.2019.4.24
[25] 李冬嫦, 付婧, 王滔, 等. 儿童眼外伤2 298例的回顾性分析[J]. 国际眼科杂志, 2022, 22(3): 521-524. doi: 10.3980/j.issn.1672-5123.2022.3.36 LI Dongchang, FU Jing, WANG Tao, et al. Retrospective analysis of 2 298 children with ocular trauma[J]. International Eye Science, 2022, 22(3): 521-524. doi: 10.3980/j.issn.1672-5123.2022.3.36
[26] Hudson JL, Fan JC, Smiddy WE, et al. Acute- and delayed-onset endophthalmitis after open globe injuries: clinical features and visual acuity outcomes[J]. Retina, 2023, 43(4): 594-599. doi:10.1097/IAE.0000000000003707
[27] Blanch RJ, Bishop J, Javidi H, et al. Effect of time to primary repair on final visual outcome after open globe injury[J]. Br J Ophthalmol, 2019, 103(10): 1491-1494. doi:10.1136/bjophthalmol-2017-311559
[28] 胡宗莉, 蒋善明, 魏欣, 等. 急诊眼外伤致伤原因及致盲因素分析[J]. 眼科新进展, 2015, 35(2): 136-140. doi:10.13389/j.cnki.rao.2015.0036 HU Zongli, JIANG Shanming, WEI Xin, et al. Analysis of causes and blinding factors of emergency ocular trauma[J]. Recent Advances in Ophthalmology, 2015, 35(2): 136-140. doi:10.13389/j.cnki.rao.2015.0036
[29] Guven S, Durukan AH, Erdurman C, et al. Prognostic factors for open-globe injuries: variables for poor visual outcome[J]. Eye(Lond), 2019, 33(3): 392-397. doi:10.1038/s41433-018-0218-9
[30] 徐君,赵靖.日常生活实践与中华民族共同体意识形成路径——以藏族群众成都就医为例[J].中央民族大学学报(哲学社会科学版), 2022, 49(6): 14-24. doi:10.15970/j.cnki.1005-8575.2022.06.003
[31] Toiv A, Durrani AF, Zhou YS, et al. Risk factors for enucleation following open globe injury: a 17-year experience[J]. Clin Ophthalmol, 2022, 16: 3339-3350. doi:10.2147/OPTH.S377137
[32] Ojuok E, Uppuluri A, Langer PD, et al. Predictive factors of enucleation after open globe injuries[J]. Graefes Arch Clin Exp Ophthalmol, 2021, 259(1): 247-255. doi:10.1007/s00417-020-04794-6
[33] Gauthier AC, Oduyale OK, Fliotsos MJ, et al. Clinical characteristics and outcomes in patients undergoing primary or secondary enucleation or evisceration after ocular trauma[J]. Clin Ophthalmol, 2020, 14: 3499-3506. doi:10.2147/OPTH.S273760
[34] Zoega GM. Fire-works related eye injuries[J]. Laeknabladid, 2022, 108(12): 537. doi:10.17992/lbl.2022.12.718
[35] 刘红霞, 王少鹏, 路晖, 等. 外伤性眼球脱位于上颌窦一例报告[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 169-170. doi: 10.6040/j.issn.1673-3770.0.2017.475 LIU Hongxia, WANG Shaopeng, LU Hui, et al. A case of traumatic eyeball removal into the maxillary sinus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 169-170. doi: 10.6040/j.issn.1673-3770.0.2017.475
[36] 马宁, 陈敏, 刘薇, 等. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19. doi: 10.6040/j.issn.1673-3770.0.2021.436 MA Ning, CHEN Min, LIU Wei, et al. Clinical characteristics and management of pediatric temporal bone fractures[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 13-19. doi: 10.6040/j.issn.1673-3770.0.2021.436
[37] 吴双. 眼外伤手术围术期健康宣教和心理护理的效果观察[J]. 河南外科学杂志, 2020, 26(6): 188-190 WU Shuang. Observation on the effect of perioperative health education and psychological nursing in eye trauma surgery[J]. Henan Journal of Surgery, 2020, 26(6): 188-190
[1] 刘蓓1,王丽丽2,朱忠桥1,杜善双1 . 玻璃体切割联合ARTISAN虹膜夹人工晶体植入治疗外伤性晶状体脱位[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 87-89.
[2] 王绍美,刘德生,李银柱 . 经鼻填充鼻中隔软骨修复眶内侧壁骨折[J]. 山东大学耳鼻喉眼学报, 2007, 21(3): 209-211 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 杨长亮,黄治物,姚行齐,诸勇,孙艺 . 正常气骨导听性脑干反应及其应用[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 9 -13 .
[2] 曹忠良 . 颌面复合伤155例临床分析[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 89 -89 .
[3] 毕景云 . 鼻中隔矫正术后血肿的处理[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 90 -91 .
[4] 刘大昱,潘新良,雷大鹏,许风雷,张立强,栾信庸 . 梨状窝内侧壁癌的手术治疗[J]. 山东大学耳鼻喉眼学报, 2007, 21(1): 8 -11 .
[5] 楼正才 . 掌拳击伤鼓膜损伤机制及临床特点分析[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 188 -188 .
[6] 刘 艳,刘新义,王金平,李大健 . 后鼓室解剖结构测量观察及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 218 -221 .
[7] 赵 敏,王守森,甄泽年,陈贤明,王茂鑫 . 鼻内镜联合显微镜行蝶窦及经蝶鞍区微创手术[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 244 -245 .
[8] 伦 杰,吕心红 . 鼻部脂溢性角化病1例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 252 -252 .
[9] 王红霞,王鹏程 . NSE、S100及GFAP在视网膜母细胞瘤中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 263 -264 .
[10] 黄 方,黄海琼,黄建强,何荷蕃 . 支气管内镜视频监视系统在小儿气管-支气管异物诊治中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 276 -277 .