眼内异物相关性眼内炎患者手术治疗效果及影响因素分析  

The influencing factors and the effect of surgical treatment in patients with intraocular foreign body related endophthalmitis

作　　者：张莹[1] 苑悦悦 李素霞[1] Zhang Ying;Yuan Yueyue;Li Suxia(Department of Ophthalmology,the First Afiliated Hospital of Zhengzhou University,Henan Provincical Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第12期941-946,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析眼内异物相关性眼内炎患者手术治疗效果及其影响因素。方法回顾性队列研究。分析郑州大学第一附属医院2018年1月至2020年12月56例(56眼)眼内异物相关性眼内炎的临床资料。随访6个月~1年。观察眼内异物相关性眼内炎患者的临床特征及手术治疗效果。结果本研究患者年龄2~80(46.08±14.90)岁;男53例, 女3例;受伤患者以中青年男性为主;异物以金属性为主, 异物主要位于眼后段;细菌培养以革兰氏阳性菌为主。所有眼内炎均得到控制。玻璃体注射万古霉素联合玻璃体切除术是治疗眼内炎的主要方式。最终视力:无光感6例, 光感2例, 手动~0.1者12例, 0.1~0.3者26例, >0.3者10例。最终BCVA(logMAR)为1.55±0.93, 显著优于术前2.31±1.63(t=4.04, P<0.001)。眼外伤评分及损伤区域与视力预后有关(H=8.06, 6.13;P=0.018, 0.043)。结论眼内异物相关性眼内炎患者治疗效果与初始视力、眼外伤评分及损伤区域有关。玻璃体注射万古霉素及玻璃体切除治疗眼内异物相关性眼内炎有效。ObjectiveTo analyze the influencing factors of surgical treatment in patients with intraocular foreign bodies(IOFBs)related endophthalmitis.MethodsThis was a retrospective cohort study.The clinical data of 56 eyes of 56 cases with IOFBs related endophthalmitis from Jan.2018 to Dec.2020 in the First Affiliated Hospital of Zhengzhou University were analyzed.The follow-up time was 6 months to 1 year.The clinical features and the surgical treatment efficacy of patients with IOFBs related endophthalmitis were observed.Results In this study,the ages of patients ranged 2 to 80 years,with an average of(46.08±14.90)years.There were 53 males and 3 females.The injured patients were mainly young and middle-aged men,most of the IOFBs were metallic,the foreign bodies were mainly located in the posterior segment of the eye,and the bacterial culture were mainly gram-positive bacteria.All endophthalmitis were controlled.Intravitreal injection of vancomycin and vitrectomy were the main treatment for endophthalmitis.Final visual acuity was no light perception in 6 cases,light perception in 2 cases,from hand movement to 0.1 in 12 cases,from 0.1 to 0.3 in 26 cases,no less than 0.3 in 10 cases.The final BCVA(logMAR)was 1.55±0.93,which was significantly better than 2.31±1.63 of preoperative BCVA(t=4.04,P<0.001).The ocular trauma score and injury areas were related to the final BCVA of IOFBs(H=8.06,6.13;P=0.018,0.043).Conclusion The preoperative BCVA,the ocular trauma score and injury areas are related to the final BCVA of patients with IOFBs related endophthalmitis.Intravitreal injection of vancomycin and pars plana vitrectomy are effective in the treatment of IOFBs associated endophthalmitis.

关 键 词：异物 眼内炎 摘出 异物 效果 治疗 

分 类 号：R779.6[医药卫生—眼科]