안면부 둔상 환자에서 유의한 안내 합병증 빈도와 안와골절 및 안면골절 유무와의 연관성
Significant Intraocular Sequelae in Orbital Blunt Trauma and Their Association with Blowout Fracture
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목적: 안면부 둔상 환자에서 안와 및 안면골절 유무에 따른 유의한 안내 합병증(significant intraocular sequelae, SIOS)의 발생 빈도의차이를 살펴보고 안외상의 치료에 도움을 얻고자 하였다. 대상과 방법: 본원에 내원한 안면부 둔상 환자 726명의 의무기록을 조사하여 안와골절만 있는 1군, 안면골절만 있는 2군, 골절이 없는3군으로 나누었고 각 군에서 홍채모양채염, 전방출혈, 망막진탕, 망막출혈, 유리체 출혈, 수정체 탈구, 망막박리, 외상성 백내장, 안구파열의 빈도를 조사하여 안와 골절 유무와의 연관성을 분석하였다. 결과: SIOS가 있는 환자의 비율이 골절이 있는 1,2군에서 골절이 없는 3군보다 유의하게 높았으며(p=0.000 by chi-square), 특히홍채모양채염과 전방출혈은 골절 군에서 유의하게 높게 발생하였다(p=0.003, p=0.008 by chi-square). 결론: 안면부 둔상으로 안와 및 안면 골절이 있는 경우 골절이 없는 경우보다 SIOS발생이 유의하게 높았으나, 안와보호 효과에 의해심각한 SIOS의 발생 비율은 더 낮았다. 이를 통해 안면부 둔상 환자의 진단 및 치료에 도움을 얻을 수 있다.
Abstract
Purpose: To investigate the frequency of significant intraocular sequelae (SIOS) in orbital blunt trauma and their association with blowout and facial bone fractures. Methods: A retrospective survey consisting of 726 patients with orbital blunt trauma who visited Korea University Medical Center was performed. Patients were divided into three groups: blowout fracture only group (group 1), facial bone fracture group (nasal bone fracture, maxillary fracture, zygoma fracture without blowout fracture, group 2), and non-fracture group (group 3). SIOS (traumatic iridocyclitis, commotio retina, hyphema, retinal hemorrhage, eyeball rupture, vitreous hemorrhage,retinal detachment, lens dislocation, traumatic cataract) were surveyed in each group, and the association between the frequency of SIOS and the presence of blowout fracture or facial bone fracture was analyzed. Results: The frequency of SIOS in the fracture groups was 83.8% in group 1 and 73.3% in group 2, which were both higher than the 67.9% in group 3, the non-fracture group (p = 0.000 by chi-square linear by linear association). Traumatic iridocyclitis and hyphema were also significantly higher in groups 1 and 2 than group 3 (p = 0.003, p = 0.008 by chi-square linear by linear association). Conclusions: SIOS was found significantly more often in the fracture group than the group without fracture, although the frequency of severe SIOS was lower in the fracture group than the non-fracture group. The results from the present study could help in the treatment and management of patients with orbital blunt trauma.
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