54例感染性眼内炎致病因素分析及临床治疗观察  

Analysis of etiological reasons and observation on the clinical treatment of 54 cases of infectious endophthalmitis

作　　者：宋华 Song Hua(Department of ophthalmology,the third peoples hospital of Luoyang,Luoyang,Henan,471000,China)

机构地区：[1]洛阳市第三人民医院(洛阳市职业技术学院第一附属医院)眼科,河南洛阳471000

出　　处：《齐齐哈尔医学院学报》2022年第24期2327-2330,共4页Journal of Qiqihar Medical University

基　　金：河南省卫健委医学教育研究项目(Wjlx2020539)。

摘　　要：目的探讨感染性眼内炎的病因诊断、临床治疗及相关疗效,以明确病例特点。方法收集2013年1月—2020年12月就诊于本院眼科的54例(55眼)感染性眼内炎病例,按病因分为外伤性眼内炎、内眼术后感染性眼内炎、内源性感染性眼内炎和感染性角膜炎。54例(55眼)病例中。外伤性眼内炎患者41例,其中工人19例,农民14例,且以中年男性居多;内眼术后感染性眼内炎患者8例(9眼);内源性感染性眼内炎患者2例;感染性角膜炎患者3例。回顾性分析发病原因、临床治疗及疾病预后等临床资料。结果54例(55眼)中外伤性眼内炎41例(75.9%),以金属类(19例、42.2%)、石子类(9例、22%)、木质类物品(7例、17.1%)等为主;内眼术后感染性眼内炎8例(9眼)(14.8%),以白内障术后为主。54例病人病原菌培养阳性率为11.1%(表皮葡萄球菌为主)。感染性眼内炎病例治疗前最佳矫正视力无光感-0.05者49例(90.70%),治疗后无光感-0.05者21例(38.90%)、0.3以上者7例(13%),经积极治疗,较多病例保留有用生活视力,经统计学分析差异有统计学意义(χ^(2)=7.7,P<0.01)。治疗前后最佳矫正视力经统计学分析,外伤性眼内炎病例差异有统计学意义(χ^(2)=6.96,P<0.01),而内眼术后眼内炎病例差异无统计学意义(χ^(2)=0.5,P=0.25)。结论开放性眼外伤和内眼手术是感染性眼内炎的两种主要原因以手术治疗为主。有效治疗和良好的初始视力是提高视力的重要因素。Objective To investigate and analyze the pathogenic factors,diagnosis,treatment and curative effect of infectious endophthalmitis.In order to clarify the relevant clinical characteristics of the disease.M ethods 54 patients(55 eyes)suffered from infectious endophthalmitis,those visited ophthalmology department of our hospital during January 2013 and December 2020,were enrolled as study subjects.It can be divided into traumatic endophthalmitis,postoperative infectious endophthalmitis,endogenous infectious endophthalmitis and infectious keratitis.Among the 54 cases(55 eyes),41 patients suffered from traumatic endophthalmitis,including 19 workers and 14 farmers.Most of them were middle-aged males.8 patients(9 eyes)with infectious endophthalmitis after internal eye operation;2 patients with endogenous infectious endophthalmitis;3 patients with infectious keratitis.The causes,clinical treatment and prognosis of the disease were analyzed retrospectively.Results Among the 54 patients(55 eyes),41cases(75.9%)were traumatic endophthalmitis,and the main causes were metals(19,42.2%),stones(9,22%)and wood articles(7,17.1%).8 cases(9eyes,14.9%)were infective endophthalmitis after intraocular surgery,which were mainly after cataract surgery.The positive rate of pathogen culture for the 54 patients was 11.1%,and staphylococcus epidermidis was the main pathogens.There were 49 cases(90.7%)with the best corrected visual acuity(BCVA)ranged from no light perception to 0.05 when initial diagnosis;after treatment BCVA of 21 cases(38.9%)ranging from no light perception to 0.05;and 7 cases(13%)with BCVA over 0.30.After active treatment,more patients retained useful living vision,and the difference was statistically significant(χ^(2)=7.72,P<0.01).The best corrected visual acuity before and after treatment showed a statistically significant difference in the cases of traumatic endophthalmitis(χ^(2)=6.96,P<0.01),but no statistically significant difference in the cases of endophthalmitis after internal eye surgery(χ^(2)=0.5,P=0.25).Conclu

关 键 词：感染性眼内炎 致病因素 药物治疗 手术治疗 

分 类 号：R771[医药卫生—眼科]