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  • 张媛,罗涛,张衡頔,谌杨,任意明,吴燕,杨黠,胡峥,刘恒,蒋炜,韩非.高原地区部队眼外伤临床分析[J].第二军医大学学报,2019,40(12):1373-1377    [点击复制]
  • ZHANG Yuan,LUO Tao,ZHANG Heng-di,CHEN Yang,REN Yi-ming,WU Yan,YANG Xia,HU Zheng,LIU Heng,JIANG Wei,HAN Fei.Clinical analysis of eye injury of soldiers in plateau areas[J].Acad J Sec Mil Med Univ,2019,40(12):1373-1377   [点击复制]
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高原地区部队眼外伤临床分析
张媛1,罗涛2,张衡頔2,谌杨2,任意明2,吴燕2,杨黠2,胡峥2,刘恒2,蒋炜2,韩非2*
0
(1. 海军军医大学(第二军医大学)长海医院眼科, 上海 200433;
2. 西部战区总医院眼科, 成都 610083
*通信作者)
摘要:
目的 探索和分析西藏驻军眼外伤的临床特点、诊治过程和预后,提出救治改进建议。方法 收集2011年1月1日至2017年12月31日保障西藏地区军人的6家医院收治的眼外伤军人的病例资料,包括人口统计学信息、致伤原因、就医时间、入院和出院时视力等,并与全军其他医院收治的军人眼外伤资料进行比较。结果 共纳入112例(116眼)眼外伤患者,男110例、女2例;机械性眼外伤111例(114眼),占99.11%(98.28%);55例(49.11%)在训练场所受伤,35例(31.25%)在休闲场所受伤,22例(19.64%)在工作场所受伤。39例(34.82%)受伤3 d后才到达西藏军区各中心医院或总医院就诊,24 h内就诊率(41.07%,46/112)低于济南军区总医院(82.37%,271/329)和全军全训部队(89.73%,131/146)的数据(P均<0.01)。70眼出院视力较入院视力提高,占有视力记录(92眼)的76.09%,其中低视力和单眼盲共33眼(35.87%,33/92)。与济南军区总医院和全军全训部队收治的军人眼外伤比较,低视力[29.35%(27/92)vs 8.03%(31/386)、6.16%(9/146)]和单眼盲[6.52%(6/92)vs 2.07%(8/386)、0.68%(1/146)]占比均较高(P均<0.05);而与15家军队三甲医院数据[10.23%(79/772)、15.28%(118/772)]相比,低视力占比较高,单眼盲占比较低,差异均有统计学意义(P均<0.05)。结论 西藏地区军人眼外伤以机械性眼外伤为主;在训练场所眼外伤发生最多,可能与高原缺氧有关;低视力和单眼盲的伤眼较多。有必要进一步提高西藏军队医院眼外伤救治能力和西藏地区伤员后送能力。
关键词:  眼外伤  军事人员  高原地区  西藏  就诊时间
DOI:10.16781/j.0258-879x.2019.12.1373
投稿时间:2019-04-13修订日期:2019-08-26
基金项目:全军后勤科研课题面上项目(CCD16J002).
Clinical analysis of eye injury of soldiers in plateau areas
ZHANG Yuan1,LUO Tao2,ZHANG Heng-di2,CHEN Yang2,REN Yi-ming2,WU Yan2,YANG Xia2,HU Zheng2,LIU Heng2,JIANG Wei2,HAN Fei2*
(1. Department of Ophthalmology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Ophthalmology, General Hospital of Western Theater Command of PLA, Chengdu 610083, Sichuan, China
*Corresponding author)
Abstract:
Objective To explore the clinical characteristics, treatment and prognosis of eye injury of soldiers in Tibet, so as to propose suggestions for treatment improvement. Methods The clinical data of soldiers with eye injury admitted to 6 hospitals serving soldiers in Tibet from Jan. 1, 2011 to Dec. 31, 2017 were collected, including demographic information, cause of injury, time for medical treatment, and visual acuity at admission and at discharge. Then the mentioned data were compared with the data of soldiers with eye injury admitted to other military hospitals. Results In total, 112 cases (116 eyes) were involved, including 110 males and 2 females. Among them, 111 cases (114 eyes) had mechanical globe injury accounting for 99.11% (98.28%), 55 cases (49.11%) had training injury, 35 cases (31.25%) had injury in spare time, and 22 cases (19.64%) had injury at worksite. Thirty-nine cases (34.82%) arrived at the central hospital or general hospital for treatment after 3 days of injury. The 24-h visit rate (41.07%, 46/112) was significantly lower than those reported by General Hospital of Jinan Military Command of PLA (82.37%, 271/329) and overall troops of full training (89.73%, 131/146) (both P<0.01). The visual acuity of 70 eyes restored better visual sight at discharge versus at admission, accounting for 76.09% of the 92 eyes with sight recording. Totally 35.87% of eyes (33/92) had poor sight or single eye blindness. The incidence rates of poor sight (29.35%[27/92]) and single eye blindness (6.52%[6/92]) were significantly higher than the data reported by General Hospital of Jinan Military Command of PLA (8.03%[31/386] and 2.07%[8/386]) and overall troops of full training (6.16%[9/146] and 0.68%[1/146]) (all P<0.05). The incidence of single eye blindness was significantly lower and the incidence of poor sight was significantly higher than the data reported by 15 grade three military hospitals (15.28%[118/772] and 10.23%[79/772]) (both P<0.05). Conclusion Mechanical injury is the main cause of eye injury in soldiers in Tibet. Eye injury in training has the highest incidence, which may be related to hypoxia at high altitude. More injured eyes are of poor sight or single eye blindness. It is necessary to strengthen treatment capacity of eye injuries and evacuation capacity of military hospitals in Tibet.
Key words:  eye injury  military personnels  plateau areas  Tibet  time for medical treatment