外伤性感染性眼内炎的临床观察  

C linical observation on traumatic infectious endopht halmi it s

作　　者：潘东艳[1] 孙伟峰[1] 顾操[1] 张睿[1] 秦海峰[1] 仲明[1] 

机构地区：[1]第二军医大学附属长海医院眼科,上海200433

出　　处：《中华眼外伤职业眼病杂志》2016年第7期481-484,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的：观察外伤性感染性眼内炎发生的危险因素、临床表现和治疗。方法分析开放性眼球外伤89例（89只眼）中眼内炎的发生与年龄、性别、致伤原因、视力、伤口情况、预防性抗生素的使用的关系以及细菌培养结果、手术情况及术后视力。采用单因素分析的统计学方法进行处理。结果本组发生眼内炎12例（13．48％）。单因素分析表明，金属致伤物、自闭伤口、穿孔伤、角膜伤口是发生眼内炎的危险因素；虹膜脱出、2代及以上抗生素的预防性全身应用是眼内炎发生的保护因素。而年龄、性别、是否存在眼内异物、是否有晶状体破裂、缝合时间是否在24 h以内与眼内炎的发生无明显关系。本组所有病例均接受了玻璃体切除手术。手术后11例（91．67％）视力为光感～0．02，1例（8．33％）视力为0．5。结论外伤性感染性眼内炎预后差，重在预防。建议对于金属物体致伤、自闭伤口、穿孔伤、角膜伤口的患者须预防性全身应用2代以上头孢类抗生素。Objective To observe the risk factors , clinical presentation and treatment of traumatic infectious endophthalmitis .Methods Eighty-nine eyes of 89 cases with open globe injury were collected . The relationship between endophthalmitis and age , sex, cause of injury,condition of wound,visual acuity, use of prophylactic antibiotics , the germiculture results , operation and postoperative visual acuity were analyzed.Results Infectious endophthalmitis occurred in 12 cases（13.48%）.The result of single factor analysis showed that metal induced injury , selfsealing wound , perforating injury and corneal wound were risk factors for infectious endophthalmitis .Iris prolapse and systemic use of prophylactic antibiotics （ 2 or 3 generation of cephalosporins ） were protective factors of infectious endophthalmitis .However, age, sex, intraocular foreign body , lens rupture and suture time whether in less than 24 hours had no obvious relations to the occurrence of infectious endophthalmitis .All patients with endophthalmitis underwent vitrectomy .After the operation,11 cases （91.67%） had visual acuity of light perception to 0.02,and 1 case（8.33%） had visual acuity of 0.5.Conclusion Traumatic infectious endophthalmitis has poor prognosis and prevention is important.Systemic use of prophylactic antibiotics of high generation is recommended for ocular trauma combined with the following factors：metal injury, selfsealing wound, perforating injury and corneal wound .

关 键 词：眼内炎 感染性 外伤性 抗生素 预防性 金属物体致伤 虹膜脱出 治疗 

分 类 号：R779.1[医药卫生—眼科]