感染性眼内炎282例临床分析  

Clinical analysis of 282 patients with infectious endophthalmitis

作　　者：陈蕊[1] 谢立信[1] 孙士营[1] 董晓光[1] 

机构地区：[1]山东省眼科研究所、青岛眼科医院,266071

出　　处：《中华眼底病杂志》2008年第6期402-405,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：山东省科技攻关计划（2004G2202154）

摘　　要：目的分析感染性眼内炎的病因和病原学特征，提高感染性眼内炎的认知和临床诊治水平。方法回顾分析282例住院治疗的感染性眼内炎患者的临床和实验室检测资料。患者中，男性206例，占73．05％；女性76例，占26．95％。年龄最小2岁，最大79岁，平均年龄（36．0±11．2）岁。除14例病情较重，无法保存眼球者以外，其余268例患者进行了玻璃体标本的病原学检测。临床和实验室检查数据采用Chi-square检验和Kappa一致性检验方法进行统计学分析，以P〈0．05为差异有统计学意义。结果282例感染性眼内炎患者中，眼外伤所致者177例，占62．77％；感染性角膜炎所致者61例，占21．63％；眼部手术后所致者32例，占11．35％；内源性眼内炎12例，占4．25％。不同年龄和病因的感染性眼内炎患者中，2～13岁者占眼外伤所致者的19．21％；14～50岁者占感染性角膜炎所致者的55．74％；51～79岁者占眼部手术后所致者的60．61％。病原体检测显示，真菌和葡萄球菌属各占30．63％，为本组感染性眼内炎患者的主要病原体。其中，致病细菌对环丙沙星敏感者最多，占81．81％；庆大霉素次之，占77．92％。结论感染性眼内炎的主要致病因素是眼外伤，真菌和葡萄球菌属是导致眼内感染的主要病原体。明确感染性眼内炎的不同致病因素、病原学特征有助于提供恰当的临床治疗。Objective To analyze the causes and pathogens of infectious endophthalmitis in our hospital. Methods The clinical data and laboratory findings of 282 inpatients with infectious endophthalmitis were retrospectively reviewed. There were 206 males（73.05%）and 76 females（26. 95% ） with a mean age of （36.04± 11.2） years （range from 2 to 79 years）. Except 14 patients who lost their eyeballs as of serious conditions, pathogen examinations of vitreous specimen had been performed for all remaining 268 cases. The clinical and laboratory data were statistically analyzed by Chi-square and Kappa consistency tests, when P〈0.05 the difference should he considered as statistically significant. Results The 4 major causes of infectious endophthalmitis of those 282 patients included ocular trauma （177 cases, 62.77%）, infectious keratitis （61 cases, 21.63%）, eye surgery （32 cases, 11.35%）, and endogenousendophthalmitis （12 cases, 4.25%）. 19.21% of the patients in ocular trauma group was 2-13 years old, 55.74% of the patients in infectious keratitis group was 14 -50 years old, and 60.61% of the patients in eye surgery group was 51-79 years old. The major pathogens were fungus and staphylococci each accounted for 30.63% of all eases. Most of the pathogenic bacteria were sensitive to ciprofloxacin （81.81%） and gentamicin （77.92%）. Conclusions The major reason of infectious endophthalmitis was ocular trauma, and the major pathogens were fungus and staphylococci. Those findings may help us to treat infectious endophthalmitis patients appropriately.

关 键 词：眼内炎/流行病学 眼内炎/微生物学 眼内炎/病因学 眼内炎/预防和控制 

分 类 号：R771[医药卫生—眼科]