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目的:观察前房冲洗术联合尿激酶治疗严重外伤性前房积血的临床疗效。方法:选择近3年来我科收治的严重外伤性前房积血患者57例(56眼),随机分为A组29例(29)眼)、B组28例(28眼),A组采用先前房注入尿激酶再行前房冲洗的方法,B组行单纯前房冲洗术。观察术中及术后并发症;术后视力、眼压情况。结果:A组术中干净清除血凝块29眼(100%),术中出血5眼(17.24%),无虹膜损伤,术后第一天矫正视力≥0.5有24眼,眼压≥21 mmHg者4眼(13.79%);B组术中仍有少量血凝块4眼(14.29%),术中出血4眼(14.29%),虹膜损伤1眼(3.57%),术后第一天矫正视力≥0.5有16眼,眼压≥21 mm Hg者8眼(28.57%)。B组术后仍有少量血凝块者加用药物治疗后吸收,两组病例中高眼压均加用药物控制正常,一周时视力无明显差异(P>0.05)。结论:前房冲洗术前先使用尿激酶治疗严重外伤性前房积血是一种操作更安全,更有效的手术方法。
Objective: To observe the clinical effect of anterior chamber irrigation combined with urokinase in the treatment of severe traumatic hyphema. Methods: Fifty-seven patients (56 eyes) with severe traumatic hyphema admitted to our department in recent 3 years were randomly divided into group A (29 eyes), group B (28 eyes), group A Anterior chamber injection of urokinase and then the method of anterior chamber flushing, B group line simple anterior chamber irrigation. Intraoperative and postoperative complications were observed; visual acuity and intraocular pressure were observed. Results: In group A, 29 eyes (100%) were cleanly removed during operation, 5 eyes (17.24%) were bleeding during operation, no iris injury was observed. On the first day after operation, corrected visual acuity was 0.5 or more in 24 eyes and intraocular pressure was ≥21 mmHg (14.29%), intraoperative bleeding in 4 eyes (14.29%) and iris injury in 1 eye (3.57%), and the first day after operation was corrected There were 16 eyes with ≥ 0.5 eyesight and 8 eyes with ≥21 mm Hg (28.57%). In group B, there was still a small amount of clot after surgery, which was absorbed after treatment with drugs. Both intraocular pressure and drug control were normal in both groups. There was no significant difference in visual acuity after one week (P> 0.05). Conclusions: Urokinase treatment of severe traumatic hyphema prior to anterior chamber irrigation is a safer and more effective method of operation.