玻璃体切除术对青光眼滤过泡感染相关性眼内炎的临床治疗效果分析  

Clinical effect of vitrectomy on treatment of glaucoma patients with filtering follicular infection-associated endophthalmitis

作　　者：刘燕 李然[2] 李喜梅[3] 郭利明 姚天宇[5] 韩艳玲[5] 梁小瑞 LIU Yan;LI Ran;LI Xi-mei;GUO Li-ming;YAO Tian-yu;HAN Yan-ling;LIANG Xiao-rui(Huaihe Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学淮河医院眼科病房,河南开封475000 [2]河南大学淮河医院外科办,河南开封475000 [3]河南大学淮河医院内科办,河南开封475000 [4]河南大学淮河医院北院急诊科,河南开封475000 [5]河南大学淮河医院南院ICU,河南开封475000

出　　处：《中华医院感染学杂志》2019年第1期117-119,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究基金资助项目(18A320021)

摘　　要：目的探讨和分析玻璃体切除术在青光眼术后滤过泡感染相关性眼内炎患者中的临床应用价值。方法选取2015年1月-2016年12月医院收治的100例青光眼术后滤过泡感染相关性眼内炎患者作为临床研究对象,采用随机数字表法将入选研究对象随机分为研究组和对照组各50例,对照组患者在未明确感染相关病原体以前给予头孢他啶作为临床药物治疗,在明确病原体以后则严格依照药敏试验结果给予药物针对性治疗。研究组患者则在对照组基础上给予玻璃体切除术的手术治疗,并分别对两组青光眼术后滤过泡感染相关性眼内炎患者的病原菌清除情况,视力变化情况,眼压变化情况进行比较和分析。结果治疗前研究组共检出病原菌59株,对照组共检出病原菌57株,两组比较差异无统计学意义;研究组患者治疗后病原菌检出株数少于对照组(χ^2=5.219,P=0.022);研究组患者治疗后0.1<视力水平<0.15的比率高于对照组(H=8.692,P=0.004);研究组患者治疗后平均眼压水平(13.20±2.42)mm Hg低于对照组患者的(14.75±2.56)mm Hg,两组比较差异有统计学意义(t=9.983,P<0.001)。结论玻璃体切除术对于青光眼术后滤过泡感染相关性眼内炎患者病原菌的清除,视力水平的改善及眼压的控制均具有良好的治疗效果。OBJECTIVE To explore the clinical value of vitrectomy in treatment of the glaucoma patients with filtering follicular infection-associated endophthalmitis.METHODS From Jan 2015 to Dec 2016,a total of 100 glaucoma patients who had postoperative filtering follicular infection-associated endophthalmitis were recruited as the study objects and randomly divided into the study group and the control group,with 50 cases in each group.The control group was treated with ceftazidime before the pathogens were identified and was given targeted drug therapy based on the result of drug susceptibility testing;the study group was treated with additional vitrectomy on basis of the treatment of the control group.The clearance rate of pathogens,visual acuity and intraocular pressure were observed and compared between the two groups of patients.RESULTS Totally 59 strains of pathogens were isolated from the study group before the treatment,and 57 strains of pathogens were isolated from the control group,and there was no significant difference between the two groups.The number of the isolated pathogens was significantly less in the study group than in the control group after the treatment(χ^2=5.219,P=0.022).The proportion of the patients with the visual acuity ranging between 0.1 and 0.15 was significantly higher in the study group than in the control group after the treatment(H=8.692,P=0.004).The average intraocular pressure of the study group was(13.20±2.42)mm Hg after the treatment,significantly lower than(14.75±2.56)mm Hg of the control group(t=9.983,P<0.001).CONCLUSION The vitrectomy can achieve remarkable effect on clearance of the pathogens,improvement of visual acuity and control of intraocular pressure of the glaucoma patients with postoperative filtering follicular infection-associated endophthalmitis.

关 键 词：青光眼 滤过泡感染 眼内炎 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]