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目的 探讨山东半岛沿海渔业人员角膜异物发病特点与防治策略.方法 回顾性分析2010年1月至2014年1月于山东省荣成市第二人民医院眼科就诊的渔业人员角膜异物4572例(4987眼).分析其发生原因、异物性质、病情分级、就诊时间以及并发症发生等特点,根据就诊时间分为早期(24 h之内)、中期(24 ～72 h)、晚期(72 h以后)3个治疗组,观察各组并发症发生情况,分析防治策略.结果 59.2％的角膜异物嵌入不足角膜厚度1/3,且一端露出角膜表面;金属角膜异物患者4185例(4356眼),占总数的91.5％;患者从受伤到我院初次就诊的时间,早期治疗组1397例(占30.6％),中期治疗组2364例(占51.7％),晚期治疗组811例(占17.7％),且3组之间角膜浸润和角膜瘢痕形成的发生率差异具有统计学意义(X2=81.56,668 P ＜0.05),随着就诊时间的延迟发生率逐渐升高.结论 渔业人员角膜异物的发病具有自身的流行病学特点,加强安全教育和外伤后及时诊治是防治角膜异物的重要方法.

Objective To investigate the clinical features,treatment and prevention of the corneal foreign bodies for the patients who were engaged in the coastal fisheries in Shandong peninsula.Methods A retrospective analysis was done for 4987 eyes of 4572 corneal foreign body patients who were fishery workers and were treatet in Rongcheng Second People' s Hospital of Shandong Province from January 2010 to January 2014.The causes of injury,characteristic of the foreign body,degree of injury,treatment time and complications were investigated.According to the treatment time,the patients were divided into early (before 24 hours),medium (24-72 hours) and late (after 72 hours) treatment groups.The complications were observed in all groups and control strategy was analyzed.Results In 59.2％ of the patients,the depth of the embedded corneal foreign body was less than 1/3 of the corneal thickness,with one end exposed outside the corneal surface.Metallic corneal foreign body was in 4185 patients accounting for 91.5％ of the total patients.There were 1397 patients (30.6％) in early treatment group,2364 patients (51.7％) in medium treatment group and 811 patients (17.7) in late treatment group.Among these three groups,the difference in the incidence of corneal infiltration and corneal scarring was statistically significant (P ＜0.05).The longer the treatment was delayed,the incidence increased.Conclusion The incidence of corneal foreign body in fishery workers has its own epidemiological characteristics.The most effective method of preventing and treating corneal foreign bodies is to improve safety education and timely diagnosis and treatment after injury.