眼科术后感染性眼内炎影响因素及其病原学分析的临床研究  

Risk factors and pathogenic bacteria of infectious endophthalmitis after ophthalmic surgery

作　　者：张雯雯 雷文静 宋鑫[1] 董魁[2] 王文革[1] Zhang Wenwen;Lei Wenjing;Song Xin;Dong Kui;Wang Wenge(Department of Hospital Infection Control,Shanxi Eye Hospital,Taiyuan 030002,China;Key Laboratory of Pathogenic Microbiology,Shanxi Eye Hospital,Taiyuan 030002,China)

机构地区：[1]山西省眼科医院院感科,太原030002 [2]山西省眼科医院微生物重点实验中心,太原030002

出　　处：《中华眼科医学杂志（电子版）》2024年第2期83-89,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：山西省自然科学研究面上项目(20210302123343);山西省眼科医院创新基金项目(C202206)。

摘　　要：目的探讨眼科手术后感染性眼内炎影响因素及其病原学。方法选取2014年1月至2023年12月于山西省眼科医院收治的眼科手术后感染性眼内炎患者65例(65只眼)和同期相同术式非眼内炎患者195例(195只眼)作为研究对象。其中,男性156例(156只眼),女性104例(104只眼);年龄4~88岁,平均年龄(65.2±10.0)岁。收集患者的基础资料、术前检查结果、感染后检查结果、术后用药情况、病原菌、治疗方法及预后等资料。平均年龄、住院时间、身体质量指数及感染症状出现时间符合正态分布以x±s表示,组间比较采用独立样本t检验;吸烟史、饮酒史、合并糖尿病、合并高血压、合并高血脂、严重疾病史、术前血红蛋白低、术前血清白蛋白低、术前未按规范使用抗菌滴眼液、日间手术、急诊手术、全身麻醉手术、术前有身体其他感染病灶、术后眼污染史及术后未规范使用抗菌滴眼液等计数资料,以例数和百分比表示。不同病原菌患者预后视力不符合正态分布采用中位数和四分位间距[M(IQR)]描述。眼内炎感染的危险因素分析采用多因素Logistic回归分析。结果65例(65只眼)感染性眼内炎患者中男性39例(39只眼),女性26例(26只眼);左眼28例(28只眼),右眼37例(37只眼);手术类型白内障手术51例(51只眼),玻璃体切割术2例(2只眼),玻璃体切割联合白内障手术6例(6只眼),青光眼联合白内障手术4例(4只眼),玻璃体腔药物注射2例(2只眼);手术三级医院24例(24只眼),二级医院31例(31只眼),民营医院10例(10只眼);超急性眼内炎40例(40只眼),亚急性眼内炎25例(25只眼),无慢性眼内炎。感染性眼内炎患者的平均年龄、住院时间及身体质量指数分别为(66.4±14.7)岁、(3.29±1.45)d及(24.41±2.09)kg/m2;非感染性眼内炎者分别为(64.8±7.8)岁、(3.06±0.97)d及(24.00±2.24)kg/m2,其差异无统计学意义(t=1.171,1.154,0.261;P>0.05)。感染性眼内炎患者的Objective The aim of this study is to investigate the influential factors of infectious endophthalmitis and its pathogenic bacteria after ophthalmic surgery.Methods A total of 65 patients(65 eyes)with infectious endophthalmitis after ophthalmic surgery and 195 postoperative non-infected patients(195 eyes)were selected as the study objects from January 2014 to December 2023.Among them,there were 156 males(156 eyes)and 104 females(104 eyes)with mean age of(65.2±10.0)years old(ranging from 4 to 88 years old).The basic data,preoperative examination results,post-infection examination results,postoperative medication,pathogenic bacteria,treatment methods and recovery of patients were collected.The average age,length of hospital stay,body mass index,and time of onset of infection symptoms follow a normal distribution expressed as x±s and compared by independent sample t-test for inter group comparison.The counting data of smoking history,drinking history,diabetes,hypertension,hyperlipidemia,serious disease history,preoperative low hemoglobin,preoperative low serum albumin,preoperative failure to use antibacterial eye drops as required,daytime surgery,emergency surgery,general anesthesia surgery,preoperative presence of other infectious lesions,postoperative eye pollution history,and postoperative failure to use antibacterial eye drops as required were described by cases and percentages.The prognosis of visual acuity in patients with different pathogens did not follow a normal distribution and was described using median and interquartile intervals[M(IQR)].The risk factors of endophthalmitis infection was calculated by multiple Logistic regression analysis.Results Among of 65 cases(65 eyes)of infectious endophthalmitis after ophthalmic surgery,there were 39 males(39 eyes)and 26 females(26 eyes).There were 28(28 eyes)cases of left eye and 37 cases(37 eyes)of right eye.There were 1 case(1 eye)with cataract surgery,2 cases(2 eyes)with vitrectomy,6 cases(6 eyes)with vitrectomy combined with cataract surgery,4 cases(4 eyes)w

关 键 词：术后感染 眼内炎 景影响因素 病原菌 

分 类 号：R779.6[医药卫生—眼科]