摘要
目的探讨感染性眼内炎的早期诊疗思路。方法回顾性临床研究。收集2012年8月至2015年8月在我院眼科住院诊治的32例32眼感染性眼内炎患者的临床资料,回顾分析其临床特点及治疗结果。结果 32例患者均存在易感危险因素,其中19例为外源性眼内炎,13例为内源性眼内炎。24例有明确致病菌,其中真菌感染3例（3眼）,细菌感染21例（21眼）;另有8例致病菌不明。房水涂片的阳性率15.62%,房水培养的阳性率12.50%,玻璃体涂片的阳性率43.75%,玻璃体培养的阳性率65.62%。6例接受玻璃体注射抗菌素,17例接受玻璃体切割手术,9例接受眼球内容物剜除手术。随访3个月后,除9例眼球摘除外,其余23例患者眼内感染均得到控制,视力不同程度提高,其中8例视力〉0.3,15例视力为0.05-0.3。结论感染性眼内炎的早期诊疗要与患者易感因素密切结合,采用玻璃体切割方法取材可以明显提高玻璃体培养的阳性率,早期玻璃体注射抗生素可有效控制眼内感染,改善感染性眼内炎的预后。
OBJECTIVE To investigate the early diagnosis and treatment ideas for infectious endophthalmitis.METHODS A retrospective clinical study scheme was adopted. From August 2012 to August 2015, 32 patients（32eyes） with infectious endophthalmitis hospitalized in our department were retrospectively analyzed for clinical fea-tures and treatment outcome. RESULTS Thirty-two patients had risk factors, including 19 cases with exogenous endophthalmitis, 13 cases with endogenous endophthalmitis. Meanwhile, 24 cases had clear pathogens, including 3cases with fungal infection, 21 cases with bacterial infection, and another 8 cases with unknown pathogens. The posi-tive rate of aqueous humor spreading slice and culture were 15.62% and 12.50% respectively. The positive rate of vitreous body spreading slice and culture respectively were 43.75% and 65.62%. Six patients were treated by intrav-itreal injection, 17 patients received vitrectomy and 9 patients received eyeball enucleation. Infection of 23 patients completed follow-up of 3 months was all controlled, and visual acuity was improved. Specifically, 8 cases were better than 0.3, 15 cases ranged from 0.05 to 0.3. CONCLUSIONS The early diagnosis and treatment of infectious endophthalmitis was associated closely with the risk factors of patients. The positive rate of vitreous body culture was improved significantly by vitrectomy. Early vitreous cavity injection could control infection effectively and improve prognosis.
出处
《中国中医眼科杂志》
2016年第3期178-182,共5页
China Journal of Chinese Ophthalmology
关键词
感染性眼内炎
早期诊断
易感因素
病原体
iinfectious endophthalmitis
early diagnosis
risk factor
pathogens
