摘要
目的分析感染性眼内炎的致病原因、临床诊治及其特点。方法回顾性病例系列研究。对山西省眼科医院2015年1月至2021年12月感染性眼内炎211例(212眼)的资料进行分析,观察患者一般资料、病原学检查、治疗及术后效果。结果患者中男性181例,女性30例;年龄(45.89±18.43)岁,范围4~86岁;外伤性眼内炎159眼(75.00%),眼部手术后感染51眼(24.06%),内源性眼内炎2眼(0.94%)。取房水或玻璃体进行病原菌培养和革兰染色,77眼病原菌培养结果阳性,阳性率36.32%,革兰氏阳性菌65眼(84.42%),革兰氏阴性菌11眼(14.29%)。根据病情选择不同的治疗,其中行玻璃体切除术者172眼(81.13%)。治疗后视力有改善,差异有统计学意义(χ^(2)=70.07,P<0.001)。治疗后眼外伤脱盲率为45.28%(72/159),眼部手术脱盲率为35.29%(18/51),内源性脱盲率为50.00%(1/2),差异无统计学意义(χ^(2)=1.85,P=0.444)。结论眼外伤和眼部手术感染是导致感染性眼内炎的主要原因。病原菌以革兰氏阳性菌为主,玻璃体切除术为主要的治疗手段,总体结果视力极差。
Objective To analyze the pathogenic causes,clinical diagnosis treatment and characteristics of infectious endophthalmitis.Methods This was a retrospective case series study.Total of 212 eyes of 211 cases with infective endophthalmitis from Jan.2015 to Dec.2021 in Shanxi Eye Hospital were analyzed.The general information,etiology,treatment and postoperative efficacy were observed.Results There were 181 males and 30 females.The mean age at presentation was(45.89±18.43)years,raged 4 to 86 years.There were 159 eyes(75.00%)with traumatic endophthalmitis and 51 eyes(24.06%)with postoperative infection,and 2 eyes(0.94%)with endogenous endophthalmitis.The aqueous humor and vitrious of all cases were smeared and Gran stained.The detection rate of pathogen was 36.32%(77/212).There were 65 eyes with a positive Gram staining result and 11 eyes with a negative result.Different treatments were selected based on the condition,and vitrectomy was performed in 172 eyes(81.13%).Visual acuity improved after treatment,and the difference was statistically significant(χ^(2)=70.07,P<0.001).After treatment,the unblinding rate of eye trauma was 45.28%(72/159),and the unblinding rate of eye surgery was 35.29%(18/51),and the endogenous unblinding rate was 50.00%(1/2),with no statistically significant difference(χ^(2)=1.85,P=0.444).Conclusion Eye trauma and surgical infection are the main causes for infectious endophthalmitis.Gram-positive bacteria is the main pathogens,and vitrectomy is the main treatment,and the overall visual acuity is extremely poor.
作者
张育
郝敏
王峻峰
宫瑞中
Zhang Yu;Hao Min;Wang Junfeng;Gong Ruizhong(Department of Pharmacy,Shanxi Eye Hospital,Taiyuan 030000,China;Department of Pharmacy,Shanxi Children’s Hospital,Taiyuan 030000,China)
出处
《中华眼外伤职业眼病杂志》
2023年第6期426-432,共7页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
眼内炎
感染性
特点
临床
因素
影响
效果
Endophthalmitis,infectious
Characteristics,clinical
Factors,influencing
Efficacy
