开放性眼外伤后感染性眼内炎的相关危险因素  

Related risk factors of infectious endophthalmitis afteRopen globe injury

作　　者：汤明霞[1] 秦时月 刘钰 曹国平[1] TANG Mingxia;QIN Shiyue;LIU Yu;CAO Guoping(Department of Ophthalmology,Taizhou City People′s Hospital of Jiangsu Province,Taizhou,Jiangsu,225300)

机构地区：[1]江苏省泰州市人民医院眼科,江苏泰州225300

出　　处：《实用临床医药杂志》2022年第20期89-92,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省泰州市人民医院院级课题(ZL201943)。

摘　　要：目的探讨开放性眼外伤后感染性眼内炎的相关危险因素。方法采用回顾性病例对照研究设计,收集2017年1月—2021年12月在泰州市人民医院住院的216例(216只眼)开放性眼外伤患者的临床资料。根据感染性眼内炎发生情况分为眼内炎组33例和非眼内炎组183例,分析年龄、性别、眼别、外伤类型、伤口闭合情况、伤口缝合时间、伤口位置、眼内异物(IOFB)类型、虹膜脱出、晶体前囊破裂、晶体悬韧带断裂、玻璃体溢出、空腹血糖等临床特征与感染性眼内炎发病的关系。结果单因素分析显示,眼内炎组与非眼内炎组在性别、外伤类型、伤口闭合情况、伤口位置、IOFB类型、晶体前囊破裂、空腹血糖方面比较,差异均有统计学意义(P<0.05)。条件逐步Logistic回归分析显示,有IOFB穿通伤(OR=3.504,95%CI:1.382~8.885)、晶体前囊破裂(OR=4.547,95%CI:1.717~12.040)、空腹血糖≥6.1 mmol/L(OR=15.012,95%CI:5.683~39.656)是并发感染性眼内炎的危险因素。结论IOFB穿通伤、晶体前囊破裂、空腹血糖≥6.1 mmol/L是开放性眼外伤后感染性眼内炎的相关危险因素,建议给予预防性全身抗生素治疗或者玻璃体内注射抗生素治疗以改善预后。Objective To investigate the related risk factors of infectious endophthalmitis afteRopen globe injury.Methods A retrospective case-control study design was adopted to collect the clinical materials of 216 hospitalized patients(216 eyes)with open globe injury from January 2017 to DecembeR2021 in Taizhou City People′s Hospital.According to the occurrence of infectious endophthalmitis,33 cases were enrolled into endophthalmitis group and 183 cases were enrolled into non-endophthalmitis group,and the relationships of clinical features such as age,gender,location of eyes,trauma type,wound closure,wound suture time,location of wounds,type of intraoculaRforeign body(IOFB),prolapse of iris,rupture of anterioRlens capsule,rupture of lens suspension ligament,vitreous overflow and fasting blood glucose with incidence of infectious endophthalmitis were analyzed.Results Univariate analysis showed that there were significant differences in gender,injury type,wound closure,location of wound,type of IOFB,rupture of anterioRlens capsule and fasting blood glucose between the endophthalmitis group and the non-endophthalmitis group(P<0.05).Conditional stepwise Logistic regression analysis showed that penetrating injury of IOFB(OR=3.504,95%CI,1.382 to 8.885),rupture of anterioRlens capsule(OR=4.547,95%CI,1.717 to 12.040)and fasting blood glucose≥6.1 mmol/L(OR=15.012,95%CI,5.683 to 39.656)were the risk factors of infectious endophthalmitis.Conclusion Penetrating injury of IOFB,rupture of anterioRlens capsule and fasting blood glucose≥6.1 mmol/L are the related risk factors of infectious endophthalmitis afteRopen globe injury,and it is recommended that prophylactic systemic antibiotic treatment oRintravitreal antibiotic injection should be given to improve the prognosis.

关 键 词：开放性眼外伤 感染性眼内炎 危险因素 眼内异物 晶体前囊破裂 空腹血糖 

分 类 号：R779.1[医药卫生—眼科] R771.2[医药卫生—临床医学]