摘要
目的分析感染性眼内炎患者致病原因、病原学培养结果、治疗情况及危险因素。方法回顾性分析参与研究患者的临床资料,采集患者眼内液标本进行病原微生物培养与鉴定,根据患者眼内炎严重程度采用不同治疗方法进行治疗,采用二元logistic回归分析白内障患者术后发生感染性眼内炎的危险因素。结果72例感染性眼内炎患者中,主要为外源性眼内炎(65例)。37例有眼部手术史,主要为白内障术后(28例),28例有外伤史,主要为穿通伤(18例)。72份眼内液标本中,28份标本培养结果阳性。病原菌以表皮葡萄球菌(9株)为主。外源性眼内炎患者与内源性眼内炎患者分泌物标本培养阳性率具有统计学意义(P<0.05)。72例感染性眼内炎患者,13.89%行前房或玻璃体注射抗菌药物及全身药物治疗,83.33%接受玻璃体切除手术,2.78%经药物及手术治疗无果行眼内容剜除术或眼球摘除术(均为内源性眼内炎)。经过治疗,眼球保留率为97.22%。患者治疗前后最佳矫正视力结果,60例术前最佳矫正视力低于0.02,45例术后最佳矫正视力低于0.02,两者对比差异有统计学意义(P<0.05)。感染组与对照组对比分析显示,年龄、合并糖尿病、手术时间、术中玻璃体溢出对比差异具有统计学意义,二元logistic回归分析显示,患者白内障手术时间>30 min、术中玻璃体溢出为白内障患者术后发生感染性眼内炎的独立危险因素。结论感染性眼内炎患者主要为外源性眼内炎,其中白内障术后眼内炎患者占比最高。患者进行白内障手术时间长、术中玻璃体溢出容易引发术后感染性眼内炎。
Objective The pathogenic causes,pathogenic culture results,treatment and risk factors of infectious endophthalmitis were analyzed.Methods The clinical data of patients who participated in the study were retrospectively analyzed.Samples of patients'intraocular fluid were collected for pathogen culture and identification.Different treatment methods were used according to the severity of endophthalmitis.Binary logistic regression was used to analyze the risk factors of infectious endophthalmitis in cataract patients after surgery.Results Among 72 patients with infectious endophthalmitis,exogenous endophthalmitis was the main cause(65 cases).37 cases had a history of eye surgery,mainly after cataract surgery(28 cases),and 28 cases had a history of trauma,mainly penetrating injury(18 cases).Among the 72 intraocular fluid samples,28 samples were positive.Staphylococcus epidermidis(9 cases)was the main pathogen.The positive rate of secretion samples from patients with exogenous endophthalmitis and patients with endogenous endophthalmitis was statistically significant(P<0.05).Among the 72 patients with infective endophthalmitis,13.89%were treated with antibiotics and systemic drugs injected into the anterior chamber or vitreous,83.33%underwent vitrectomy,and 2.78%underwent enucleation(all endogenous endophthalmitis)after drug and surgical treatment.After treatment,the eyeball retention rate was 97.22%.The results of the best corrected visual acuity before and after treatment showed that the best corrected visual acuity before operation was lower than 0.02 in 60 cases and after operation was lower than 0.02 in 45 cases.The difference between the two was statistically significant(P<0.05).The comparative analysis between the infection group and the control group showed that there were statistically significant differences in age,combined with diabetes,operation time,intraoperative vitreous overflow.Binary logistic regression analysis showed that the cataract operation time of patients was more than 30min,and intraoperative vitreous overflow was an independent risk factor for postoperative infectious endophthalmitis in cataract patients.Conclusion Patients with infective endophthalmitis are mainly exogenous endophthalmitis,of which the proportion of patients with endophthalmitis after cataract surgery is the highest.Patients with cataract surgery for a long time,intraoperative vitreous overflow is easy to cause postoperative infectious endophthalmitis.
作者
周天球
张俊芳
ZHOU Tian-qiu;ZHANG Jun-fang(Affiliated Hospital of Nantong University,Nantong 226000,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2022年第9期1053-1056,1060,共5页
Journal of Pathogen Biology
关键词
感染性眼内炎
临床特征
危险因素
infective endophthalmitis
clinical features
risk factors
