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目的 探讨外伤眼玻璃体切割术后结局和视力预后的相关因素。 方法 137只经玻璃体切割手术外伤眼 ,按自然存在因素和围手术因素录入EPIINFO软件并转入SAS分析系统中分析。 结果 手术成功 10 4只眼 (75 9% ) ,手术失败 33只眼 (2 4 1% )。最终视力小于 0 0 2的 6 3只眼 (45 9% ) ,大于或等于0 0 2的 74只眼 (5 4 1% )。多元回归结果显示 :在伤眼自然因素中视网膜脱离发生对伤眼手术失败结局影响具有显著性意义 (RR =3.0P =0 .0 2 0 ) ;对伤眼不良视力预后影响具有显著性意义 (RR =3 .2P =0 .0 0 1)。外伤 -手术时间延长 ,手术失败的危险性增加 (RR =1.0 ,P =0 .0 0 7)。在围手术因素中 ,手术复杂程度增加 ,手术失败的危险性随之增加 (RR =2 .4P =0 .0 0 0 ) ;对不良视力预后危险性也增加 (RR =2 .2P =0 .0 0 2 )。有术后并发症比无并发症发生手术失败的危险性高 7 5倍 (RR =7.5P =0 .0 0 0 ) ;对不良视力预后的危险性高3 1倍 (RR =3 .1P =0 .0 2 2 )。 结论 伤眼视网膜脱离发生、手术复杂程度及术后并发症发生是伤眼手术后不良结局和视力不良预后的重要危险因素。
Objective To investigate the related factors of outcome and vision prognosis after vitrectomy in traumatic eyes. Methods One hundred and fourty-seven patients underwent vitrectomy for traumatic eyes. EPIINFO software was entered according to the factors of natural appearance and perioperative factors and transferred to SAS analysis system. Results The operation was successful in 10 4 eyes (75 9%) and failed surgery in 33 eyes (2 4 1%). Sixty-three eyes (45 9%) with a final visual acuity of less than 0.002 and 74 eyes (541%) with a greater than or equal 0.002. Multiple regression results showed that retinal detachment had a significant effect on the outcome of failed eye surgery (RR = 3.0P = 0.020) in the natural factors of wound injury, and had significant effect on the prognosis of bad eyesight ( RR = 3 .2P = 0 .0 0 1). Trauma - The longer the procedure, the greater the risk of failure (RR = 1.0, P = .07). Among the perioperative factors, the increased surgical complexity and the increased risk of surgical failure (RR = 2.4P = 0.000), and the increased risk of adverse visual acuity (RR = 2.2P = 0). 0 0 2). The risk of postoperative complications was 75% higher than that without complications (RR = 7.5P = 0.0000). The risk of adverse visual outcomes was 31 times higher (RR = 3.1P = 0 .0 2 2). Conclusion The occurrence of retinal detachment, the complexity of operation and the occurrence of postoperative complications are the important risk factors for the poor outcome and poor prognosis of eyes after operation.