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目的了解急性重度眼烧伤的临床特点、预后及并发症发生情况。方法对笔者单位病案室保存的1977-2002年住院眼烧伤患者135例(155只眼)的病历进行回顾性统计分析。分析不同深度、原因眼烧伤的眼表修复率、修复时间、致盲情况及并发症。结果治疗后Ⅲ度眼烧伤的修复时间短于Ⅳ度眼烧伤,其修复率也明显高于Ⅳ度眼烧伤(P<0．01);在不能修复的Ⅳ度眼烧伤中,酸烧伤致角膜穿孔6只眼,显著高于碱烧伤(1只眼,P<0．05)。Ⅲ度眼烧伤视力≥0．05者有 38只眼,<0．05者51只眼;Ⅳ度眼烧伤视力≥0．05者0只眼,<0．05者66只眼。78只酸、碱烧伤眼中,52只眼致盲,致盲率为66．7％;77只热烧伤眼中,65只眼致盲,致盲率为84．4％。Ⅲ度眼烧伤的并发症发生率低于Ⅳ度眼烧伤。其中Ⅲ度眼烧伤角膜穿孔、睑球粘连的发生率(1．1％、36．0％)均显著低于Ⅳ度眼烧伤(27．3％、59．1％,P<0．01)。在酸烧伤患者中,角膜穿孔及睑外翻的发生率 (29．2％、37．5％)较高。而热烧伤患者中眼睑球粘连的发生率(53．2％)较高。结论Ⅳ度眼烧伤伤后的预后差,致盲率高。目前的治疗方法尚不能完全改善其视功能及预后,有待进一步研究。
Objective To investigate the clinical features, prognosis and complications of acute severe ocular burns. Methods Retrospective statistical analysis was performed on the medical records of 135 cases (155 eyes) of hospitalized burns in the hospital from 1977 to 2002 which were saved in the unit case of the author. Analysis of different depths, causes ocular surface repair eye burns, repair time, blindness and complications. Results The repair time of third-degree ocular burns was shorter than that of fourth degree ocular burns, and the repair rate was also significantly higher than that of fourth degree ocular burns (P <0.01). In the fourth degree ocular burns that can not be repaired, Perforation of 6 eyes, significantly higher than the alkali burn (1 eye, P <0.05). Ⅲ degree eye burn visual acuity ≥ 0.05 were 38 eyes, <0.05 were 51 eyes; Ⅳ degree eye burn visual acuity ≥ 0.05 were 0 eyes, <0.05 was 66 eyes. Of the 78 acid and alkali burns, 52 eyes were blind, with a blinding rate of 66.7%. Of the 77 eyes with hot burns, 65 eyes were blind with a blindness rate of 84.4%. The incidence of third-degree ocular burns was lower than that of grade IV ocular burns. The incidence of corneal perforation and symblepharon in grade Ⅲ eye burns (1.1%, 36.0%) were significantly lower than those in grade Ⅳ eye burns (27.3%, 59.1%, P <0.01) . In patients with acid burns, the incidence of corneal perforation and ectropion (29.2%, 37.5%) was higher. The incidence of eyelid adhesion in patients with thermal burns was higher (53.2%). Conclusion The prognosis of ocular ocular burn injuries is poor and the rate of blindness is high. The current treatment can not completely improve its visual function and prognosis, pending further study.