严重化学性眼损伤——临床结果和相关社会经济因素。

Scars, burns & healing Pub Date : 2023-09-27 eCollection Date: 2023-01-01 DOI:10.1177/20595131231180367
Borja Salvador-Culla, Jeffrey Hogg, Arthur Okonkwo, Julie Mulroy, Gustavo S Figueiredo, Francisco C Figueiredo
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引用次数: 0

摘要

目的:描述三级医院严重急性化学性眼损伤的临床结果、管理和社会经济影响。方法:在2013年4月至2015年9月期间,37名患者需要紧急入住皇家维多利亚医院眼科病房。评估了人口统计学、最佳矫正远距离视力(BCDVA)、病原体、角膜缘干细胞缺乏症(LSCD)程度、管理和社会经济数据。结果:入院时的平均年龄为34.5岁(SD 16.3;范围16-82);男性30例(81.1%);双侧22例(59.5%),病因:碱30例(81.1%);酸中毒3例(8.1%);袭击15例(40.5%),工伤事故12例(32.5%),家庭事故9例(24.3%),不明原因1例(2.7%)。11名患者(29.7%)失业,18名患者(48.6%)为劳动者,3名患者(8.1%)为学生,3名(8.1%的)为退休人员,2名患者(5.4%)为专业人员。平均入院时间为5天(SD 3.2;范围1-12)。平均随访时间为170.5天(范围1-946)。平均入院费用为2478英镑(274-5785英镑)。5名患者(13%;7只眼睛)出现角膜缘干细胞完全或部分缺乏,均为攻击性疾病。结论:在我们的研究中,主要病原体是碱,其中工作年龄的年轻男性最常见。许多患者需要长期住院和昂贵的随访。大多数案件是袭击,大多发生在失业患者身上。所有角膜缘干细胞缺乏的病例都是由攻击引起的。我们认为,社会经济因素在化学性眼损伤的原因、严重程度和成本中起着重要作用。概述:急性化学性眼损伤对患者的视觉功能结果和视力相关的生活质量有着重大而广泛的影响,给受影响的个人、他们的家庭和社会带来了巨大的负担。我们相信,通过了解社会经济环境,我们不仅可以执行安全措施,以应对我们社区日益严重的化学性眼损伤率,还可以与社区制定合作计划,教育民众了解化学性眼伤害的严重性,并与地方当局、,试图了解各地区袭击事件的聚集性,并解决相关的社会经济风险因素,如失业。鉴于近年来使用化学品的袭击事件不断增加,评估是否有足够的受害者支持方案,并与相关的地方、区域和国家当局建立良好的互动关系,以确保社区安全服务的各个方面都到位,能够根据警察和内政部的指导方针解决任何潜在的不足之处,这一点也很重要。请记住,最好的行动计划始终是预防。然而,当眼损伤确实发生时,很明显,尽管我们目前提供了最好的医疗和外科护理,但仍会导致严重的发病率和视觉后遗症,并影响受害者的社会经济地位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Severe chemical eye injuries - clinical outcomes and associated socio-economic factors.

Severe chemical eye injuries - clinical outcomes and associated socio-economic factors.

Severe chemical eye injuries - clinical outcomes and associated socio-economic factors.

Severe chemical eye injuries - clinical outcomes and associated socio-economic factors.

Aims: To describe clinical outcomes, management, and socio-economic impact of severe acute chemical eye injuries in a tertiary hospital.

Methods: 37 patients required emergency admission to the Royal Victoria Infirmary eye ward between April 2013 and September 2015. Demographics, best corrected distance visual acuity (BCDVA), causative agent, degree of limbal stem cell deficiency (LSCD), management and socio-economic data were evaluated.

Results: Mean age on admission was 34.5 years (SD 16.3; range 16-82); 30 males (81.1%); 22 bilateral (59.5%). Causative agent: alkali in 30 cases (81.1%); acid in three cases (8.1%); and unknown in four cases (10.8%). Fifteen cases (40.5%) were assaults, 12 (32.5%) work-related accidents, nine (24.3%) domestic accidents and one (2.7%) undetermined. Eleven patients (29.7%) were unemployed, 18 (48.6%) were labourers, three (8.1%) were students, three (8.1%) were retired and two (5.4%) were professionals. Mean admission time was five days (SD 3.2; range 1-12). Mean follow-up time was 170.5 days (range 1-946). Mean cost of admission was £2478 (range £274-5785). Five patients (13%; seven eyes) developed total or partial limbal stem cell deficiency, all being assaults.

Conclusions: Main causative agent in our study was alkali, with young men in the working age being most frequently involved. Many patients required prolonged hospital admission and costly follow-up. The majority of cases were assaults, mostly occurring in unemployed patients. All the limbal stem cell deficiency cases were due to assaults. We believe that socio-economic factors play an important role in the cause, severity and cost of chemical eye injuries.

Lay summary: Acute chemical eye injuries have a significant and extensive impact on patients' visual function outcomes and vision-related quality of life, with consequent enormous burden to affected individuals, their families and society. We believe that by understanding the socio-economic environment, we may not only be able to enforce safety measures to tackle the increasing rate of severe chemical eye injuries in our community, but also to develop collaborative programmes with the community, educating the population on the seriousness of chemical eye injuries, and with the local authorities, trying to understand the clustering of assaults in areas and tackling the associated socio-economic risk factors, such as unemployment. Given the increasing rate of assaults using chemicals in recent times, it is also important to assess availability of adequate victim support programmes and develop good interaction with relevant local, regional and national authorities to ensure all aspects of community security service are in place to be able to address any potential deficiencies in line with police and home office guidelines. Keeping in mind that the best action plan is always prevention. However, when an ocular injury does occur it is evident that significant morbidity and visual sequelae can result and affect the socio-economic status of the victims despite our best current medical and surgical care.

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