目的 了解儿童眼外伤患者致伤因素及临床特征,分析感染性眼内炎的影响因素。方法 以2017年1-10月中山眼科中心眼外伤科急诊入院的144名眼外伤儿童为研究对象,收集患者及家庭一般资料、致伤因素及临床特征,分析感染性眼内炎的影响因素。结果 儿童开放性眼外伤患者131名中并发感染性眼内炎的患儿达28名,发生率为21.4%;首次就诊时间超过8 h的患儿发生眼内炎的风险增加5.379倍;留守儿童首次就诊时间超过8 h的风险增加1.570倍,首次就诊时间是否超过8 h为留守儿童与开放性眼外伤并发感染性眼内炎的中介效应变量(Z=2.09,P=0.036)。结论 儿童眼外伤患者发生感染性眼内炎受首次就诊时间影响,留守儿童因首次就诊时间延误更值得社会关注。
Abstract
Objective To explore the characteristic of pediatric ocular traumatic children, in order to explore the risk factors of pediatric post-traumatic endophthalmitis. Methods Totally 144 ocular trauma children admitted by Zhongshan Ophthalmic Center from January to October 2017 were enrolled in this study.Demographic characteristic, injury factors and clinical features were recorded.And the influencing factors of post-traumatic endophthalmitis were analyzed. Results It was observed that 28 (21.4%) patients out of 131 open ocular trauma developed endophthalmitis.For ocular traumatic children, primary repair above 8 hours increased the risk of endophthalmitis by 5.379 times.Left-behind children increased the risk of primary repair over 8 hours by 1.570 times.Primary repair within 8 hours played an intermediary role between left-behind children and endophthalmitis(Z=2.09,P=0.036). Conclusion Pediatric post-traumatic endophthalmitis is associated with primary repair within 8 hours or not, and left-behind children with delayed primary repair should be given more concern.
关键词
儿童眼外伤 /
感染性眼内炎 /
首次就诊时间 /
留守儿童
Key words
pediatric ocular trauma /
post-traumatic endophthalmitis /
primary repair /
left-behind children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 颜华.我国眼外伤救治现状与面临的挑战[J]. 中华眼科杂志,2015,51(8):561-564.
[2] Rishi E, Rishi P, Koundanya VV, et al.Post-traumatic endophthalmitis in 143 eyes of children and adolescents from India[J]. Eye (Lond),2016,30(4):615-620.
[3] 雷婧宇.住院儿童眼外伤的类型和疗效分析[D]. 杭州:浙江大学,2013.
[4] Gunes A, Kalayc M, Genc O, et al.Characteristics of open globe injuries in preschool children[J]. Pediatr Emerg Care,2015,31(10):701-703.
[5] 马琳,马绍珍,张鑫,等.儿童眼外伤调查分析[J]. 眼外伤职业眼病杂志,2010,32(9):663-665.
[6] Okpala NE, Umeh RE,Onwasigwe EN.Eye injuries among primary school children in Enugu, Nigeria:rural vs urban[J]. Ophthalmol Eye Dis,2015,7:13-19.
[7] 原阿丽,卢英俊.儿童气质的发展认知神经科学研究进展及其启示[J]. 幼儿教育,2014,33(1):44-48.
[8] Kutluturk KI, Sogutlu SE, Kubaloglu A, et al.Characteristics of pediatric and adult cases with open globe injury and factors affecting visual outcomes:a retrospective analysis of 294 cases from Turkey[J]. Ulus Travma Acil Cerrahi Derg,2018,24(1):31-38.
[9] Puodziuviene E, Jokubauskiene G, Vieversyte M, et al.A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma[J]. BMC Ophthalmol,2018,18(1):10.
[10] 张曼姝.儿童眼外伤的致伤因素与特征分析[D].郑州:郑州大学,2014.
[11] 高雁.眼外伤的相关因素分析及防治护理对策[J]. 中国医院统计,2010,17(4):318-320.
[12] Chang IT, Prendes MA, Tarbet KJ, et al.Ocular injuries from fireworks:the 11-year experience of a US level I trauma center[J]. Eye (Lond),2016,30(10):1324-1330.
[13] 杨世民.玩具枪子弹眼外伤临床观察[J]. 中华眼外伤职业眼病杂志,2013,35(3):225-226.
[14] Zhang Y, Zhang MN, Jiang CH,et al.Endophthalmitis following open globe injury[J]. Br J Ophthalmol,2010,94(1):111-114.
[15] Li X, Zarbin MA, Bhagat N.Pediatric open globe injury:a review of the literature[J]. J Emerg Trauma Shock,2015,8(4):216-223.
[16] Batur M, Seven E, Akaltun MN, et al.Epidemiology of Open Globe Injury in Children[J]. J Craniofac Surg,2017,28(8):1976-1981.
[17] Shah M, Shah S, Khandekar R.Ocular injuries and visual status before and after their management in the tribal areas of Western India:a historical cohort study[J]. Graefes Arch Clin Exp Ophthalmol,2008,246(2):191-197.
[18] Narang S, Gupta V, Simalandhi P, et al.Paediatric open globe injuries.Visual outcome and risk factors for endophthalmitis[J]. Indian J Ophthalmol,2004,52(1):29-34.
[19] Schrader WF.Epidemiology of open globe eye injuries:analysis of 1026 cases in 18 years[J]. Klin Monbl Augenheilkd,2004,221(8):629-635.
[20] Khan S, Athwal L, Zarbin M, et al.Pediatric infectious endophthalmitis:a review[J]. J Pediatr Ophthalmol Strabismus,2014,51(3):140-153.
[21] Essex RW, Yi Q, Charles PG, et al.Post-traumatic endophthalmitis[J]. Ophthalmology,2004,111(11):2015-2022.
[22] Gupta A, Srinivasan R, Gulnar D, et al.Risk factors for post-traumatic endophthalmitis in patients with positive intraocular cultures[J]. Eur J Ophthalmol,2007,17(4):642-647.
[23] 刘霞,张跃兵,张国华,等.济宁市农村留守儿童意外伤害调查[J]. 中国健康心理学杂志,2016,24(1):78-80.