摘要
目的 探讨青光眼术后滤过泡感染的危险因素及临床表现和预后情况.方法 回顾性分析2012年5月至2015年5月行青光眼手术的1 280例患者的临床资料,采用Logistic单因素及Logistic多因素分析青光眼术后滤过泡感染发生的危险因素,并观察患者临床表现和预后情况.结果 1280例青光眼手术患者术后滤过泡感染例数为118例,感染率为9.22%.患者入院时最佳矫正视力为0.1-1.0,感染控制后视力保持治疗前水平.治疗前眼压为（21.63±5.69）mmHg（1 mmHg=0.133 kPa）,治疗后眼压（15.63±4.78）mmHg.患者致病菌感染主要为葡萄球菌、大肠杆菌、绿脓杆菌、表皮葡萄球菌.经单因素分析,年龄、手术方式、术中抗代谢药物的应用、术前糖尿病、并发下方滤过泡、术中应用可松解缝线、同时行白内障手术的患者其术后滤过泡感染率显著升高,而术中应用抗生素患者术后感染率显著下降（P〈0.05）.经Logistic多因素分析,手术方式、术中抗代谢药物应用、术前糖尿病、合并下方滤过泡、术中应用可松解缝线是青光眼术后滤过泡感染的独立危险因素,而术中应用抗生素则是保护因素.结论 青光眼术后滤过泡感染发生率较高,手术方式、术中抗代谢药物应用、术前糖尿病、下方滤过泡、术中应用可松解缝线是青光眼术后滤过泡感染的独立危险因素.
Objective To investigate the risk factors and clinical manifestations and prognosis of glaucoma surgery infections.Methods The clinical data of 1280 patients underwent routine glaucoma surgery were retrospectivly analyzed from May 2012 to May 2015.The risk factors in glaucoma surgery infection, the clinical manifestations and prognosis were analyzed by logistic univariate and multivariate analysis.Results Among the 1280 cases, postoperative bleb infection in 118 cases, and the infection rate was 9.22%.The best corrected visual acuity was 0.1 to 1.0 at admission, the vision kept the pre-treatment levels after infection control.Before treatment, the IOP was （21.63±5.69） mmHg, after treatment, the IOP was （15.63±4.78） mmHg.The main infected pathogenic bacteria was Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus epidermidis.Univariate analysis showed that, age, surgical approach, intraoperative application of antimetabolite drugs, preoperative diabetes, concurrent bleb bottom, intraoperative releasable sutures, concurrent cataract surgery patients had high postoperative bleb infection rate, and the postoperative infection rate of patients with intraoperative use of antibiotics decreased significantly （P〈0.05）.Logistic multivariate analysis showed that, surgical approach, intraoperative antimetabolites application, bleb bottom, preoperative diabetes, intraoperative use of releasable sutures were independent risk factors for glaucoma surgery infection, and intraoperative use of antibiotics was a protective factor.Conclusions Glaucoma surgery has high incidence of bleb infection, surgical approach, intraoperative antimetabolites application, preoperative diabetes, bleb underneath, intraoperative releasable sutures in glaucoma surgery are infection independent risk factors, and hence, the management of high-risk patients should be strengthend, in order to improve the effect of glaucoma surgery.
出处
《中国实用医刊》
2017年第7期95-97,共3页
Chinese Journal of Practical Medicine
关键词
青光眼
滤过泡感染
危险因素
临床表现
预后
Glaucoma
Bleb infection
Risk factors
Clinical manifestations
Prognosis
