白内障囊外摘除术后眼内炎的临床研究  

Endophthalmitis after Extracapsular Cataract Extraction

作　　者：骆荣江[1] 邵应峰[2] 马翠萍[1] 龙崇德[2] 朱慧萍 刘韶瑞[1] 

机构地区：[1]中山大学附属第一医院眼科,广州510080 [2]中山大学眼科中心,广州510080 [3]南雄市中医院,广东南雄512400

出　　处：《中国康复》2009年第6期424-426,共3页Chinese Journal of Rehabilitation

摘　　要：目的:分析白内障囊外摘除术后眼内炎的情况,探讨其防治措施。方法:采用单因素分析及非条件Logistic逐步回归分析方法,回顾性分析白内障囊外摘除人工晶状体植入患者9 660例(10 898眼)术后并发眼内炎的发生率,筛查分析其发生眼内炎的危险因素。结果:10 898眼中共有27眼术后发生眼内炎(0.25%),危险因素主要有术中玻璃体溢出、并发糖尿病、年龄较大(≥70岁)、大手术切口和手术历时较久(≥1 h)等;发现眼内炎后立即行玻璃体注药联合全身给药或玻璃体手术,并行细菌学检查,27例中,16例细菌培养结果阳性,分别为表皮葡萄球菌7例,粪肠球菌(D群)4例,肺炎链球菌3例,真菌感染2例,其余11例标本培养3次均无细菌生长。治疗后7眼无光感,3眼行眼球摘除。结论:白内障囊外摘除术后并发眼内炎有诸多危险因素,采取规范的围手术期处理措施、推广小切口巩膜隧道式手术、提高基层医生的手术技能、减少玻璃体溢出等有望降低眼内炎的发生率。Ohjective： To analyze the risk factors of endophthalmitis after extracapsular cataract extraction and discuss the methods of prevention and treatment. Methods： The relative factors of endophthalmitis were analyzed by monofactor analysis of variance and logistic stepwise regression analysis of non-condltion with the case controlled study method of 9660 cases （10898 eyes） subject to extracapsular cataract extraction. Results： Twenty-seven eyes suffered from endophthalmitis in all cases undergoing extracapsular cataract extraction. The attack rate of endophthalmitis after phacoemulsification surgery was 0. 247%. The main risk factors were vitreous loss during surgery, diabetes, old ages （≥70 yrs）, big incision and long operative time （≥ 1 h）. They received vitreetomy and intravitreal injection. Microbiological examination revealed that 16 eyes were positive for bacterial culture： staphylococcus epidermidis was fond in 7 eyes, denterococcus faecalis was fond in 4 eyes, streptococcus pneumoniae was fond in 3 eyes and fungus was fond in 8 eyes. Eleven eyes were negative, for three microbiological examinations. Seven of them lost vision after treatment and 7 of them were subjected to the extraction of eyeball. Conclusion： Lots of factors caused endophthafmitis after extracapsular cataract ex- traction. Endophthalmitis befter extracapsular cataract extraction may be controlled by reinforcing management and avoiding vitreous loss during surgery and promoting small sublittle tunnel incision cataract extraction.

关 键 词：白内障囊外摘除术 眼内炎 危险因素 分析 

分 类 号：R779.66[医药卫生—眼科] R771[医药卫生—临床医学]