بررسی عوارض چشمی دیررس گاز خردل در مجروحین شیمیایی جنگ ایران وعراق

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کمیته پژوهشی دانشجویی، اینترن دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران ، ایران

2 دانشیار گروه چشم پزشکی دانشگاه علوم پزشکی شهید بهشتی، تهران ، ایران

3 کارشناس ارشد آمار زیستی، مربی گروه علوم پایه، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

4 چشم پزشک، استاد دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

5 متخصص چشم پزشکی . فلوشیپ جراحی پلاستیک و ترمیمی چشم. بیمارستان لبافی نژاد. دانشگاه علوم پزشکی شهید بهشتی

چکیده

مقدمه و اهداف
چشم در مقابل گاز خردل به علت سطح رطوبت آن خیلی حساس است، با توجه به عوارض دیررس این گاز، این مطالعه جهت بررسی عوارض طولانی مدت گاز خردل  انجام گرفته است.
 مواد و روش ها
این پژوهش به روش توصیفی در 300 نفر از مجروحین شیمیائی جنگ تحمیلی که سن آنان بین 75-40 سال بود و از زمان مصدومیت آنان 33-28 سال گذشته بود، انجام گرفت. یک معاینه کامل چشمی توسط یک متخصص چشم انجام شد. عوارض در چهار گروه شامل : طبیعی، خفیف، متوسط و شدید تقسیم بندی گردید، نتایج توسط آزمونX2 مورد قضاوت آماری قرار گرفت و سایر نتایج در قالب آمارهای توصیفی اعلام گردید.
یافته ها
از 300 مجروح جنگی 37.5%سن بین 50-46 سال،79% سابقه یک بار مصدومیت،13.4%سابقه دوبارمصدومیت،  6.6% سابقه سه بار مصدومیت و1% بیش از سه بار،42% سابقه بستری،77.6% سابقه مصرف دارو، بیشترین شکایات، خارش (42.3%)، سوزس (38.3%) و احساس خشکی چشم (37%). بیشترین عوارض پلک ها اختلال غدد میبومین (39.4%). بیشترین عوارض ملتحمه، آنومالی های عروقی (46.6%). بیشترین عوارض ناحیه لیمبوس، ایسکمی (12%) و بیشترین عوارض قرنیه، اختلال سلول های اپی تلیال (13.4%) بودند. اعمال جراحی قبلی انجام شده: بستن پونکتوم اشکی (19.4%)، پیوند قرنیه نفوذی (0.33%)، تارسورافی (0.66%)، کشیدن ملتحمه روی قرنیه (1%)، پیوند غشای آمنیونی (0%)، پیوند سلول های بنیادی (66/2%) و پیوند لایه ای قرنیه (66/0%) بودند. از نظر شدت ضایعات: نرمال(53.34%)، خفیف(33/33%)، متوسط(9.33%) و شدید(4%) بودند.
 نتیجه گیری
یافته های پژوهش نشان داد که گازخردل دارای عوارض تاخیری در چشم است وآنومالی های عروقی ملتحمه و اختلال سلول های اپی تلیال قرنیه بیشترین عوارض بودندوعوارض خفیف نسبت به متوسط و شدید بیشتر بود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Delayed Ocular Complications of Mustard Gas in Iranian Veterans

نویسندگان [English]

  • Paria Ghasemi-Broumand 1
  • Hossein Mohammad Rabie 2
  • Seyed Mehdi Tabatabaee 3
  • Mohammad Ghassemi-Broumand 4
  • Kourosh Shahraki 5
1 Student Research Committee, Intern, School of Medicine, Shahid Biheshti University of Medical Sciences.Tehran.Iran.
2 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 MSc in Biostatistics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Professor in Ophthalmology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Ophthalmuc plastic and reconstructive surgery fellowship. Shahid beheshti university of medical sciences. Tehran. Iran
چکیده [English]

Background and Aim: Eyes are very sensitive to Sulfur Mustard gas (SM) because they have wet surfaces. Considering the late complications of eye due to mustard gas exposure in warfare patients, the present study was conducted to evaluate the late complications of the eye.
Materials and Methods: In the current descriptive study, we evaluated 300 male patients aged between 40-75 years old whose mustard gas injury period was about 27-32 years before. A complete eye examination by an ophthalmologist was done. The complications were divided in 4 grades: normal, mild, moderate, and severe. The results were reported as x2 and relative frequencies.
Results: Out of 300 warfare patients, 37.5% were aged 46-50 years old, 79% were injured with mustard gas once, 13.4% twice, 6.6% three times, and 1% more than 3 times, 42% had hospitalization, and 77.6% used drugs. The most common symptoms were itching (42.3%), burning (38.3%), and dryness (37%) and the most prevalent complication of the lid was MGD (39.4%). Also, the most prevalent complication of Conjunctiva was vascular anomalies (46.6%), the most common complication of limbus was ischemia (12%), and the most common complication of cornea was epithelial defect (13.4%). Among the prevalent ocular surgeries were punctual occlusion (19.4%), penetrating keratoplasty (PK) (0.33%), tarsoraphy (0.66%), conj.flap (1%), amniotic membrane transplantation (0%), stem cell graft (2.66%), and lamellar keratoplasty (LK) (0.66%), in the order of frequency. The degrees of complications were 53.34% for normal, 33.33% for mild, 9.33% for moderate, and 4% for severe cases.
Conclusion: Conjunctival vascular abnormalities and epithelial defect were the most significant signs among the sulfur mustard chemical war victims. Having reached the mentioned conclusions, it can be stated that mild complications were more than moderate and severe ones.

کلیدواژه‌ها [English]

  • Mustard gas
  • Delayed ocular complications
  • Veterans

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دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 7، شماره 1
فروردین و اردیبهشت 1397
صفحه 30-41

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سابقه مقاله

  • تاریخ دریافت: 17 آذر 1395
  • تاریخ بازنگری: 06 آبان 1396
  • تاریخ پذیرش: 10 آبان 1396
  • تاریخ اولین انتشار: 01 فروردین 1397

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