玻璃体手术治疗眼内炎的预后因素分析

Analysis of prognostic correlative factors in vitrectomied eyes of traumatic endophthalmitis

目的探讨影响玻璃手术治疗各类眼内炎预后的相关因素。方法回顾性分析60例（60，眼）眼内炎患者玻璃体手术的临床资料。对患者的性别、年龄、致伤物类型、视力分级、是否合并眼内异物、是否合并视网膜脱离、视网膜血管炎、感染的病原菌等诸多因素进行统计分析。结果患者的性别、年龄、致伤物类型、视力分级、是否合并异物存留等因素均未显示出对预后有显著性影响（P〉0．05）；术前及术中合并视网膜脱离、视网膜血管炎者的视力预后较差，且由于视网膜脱离等可增加手术的复杂程度，而手术方式的复杂性每增加一个等级，视力预后较差的危险性增加3．1倍（OR值=6．78,χ^2=10．07，P〈0．01）；眼内炎感染的病原菌（白色念珠菌感染或蜡样芽胞杆菌感染）也与视力预后较差有显著相关性（OR值=5．91,χ^2=9．99，P〈0．05）。结论眼内炎患者玻璃体手术后视力的预后效果与合并眼底损伤、手术复杂历时较久、蜡样芽胞杆菌感染或白色念珠菌感染等因素密切相关。

Objective To evaluate the correlative factors of visual acuity（VA） among patients with vitrectomy of traumatic endophthalmitis. Methods A retrospective analysis on clinical data was performed of 60 patients（60 eyes）with vitrectomy for traumatic endophthalmitis. Statistical analysis is made based on sex, age, type of injury matter, VA, intraocular foreign body, retinal detachment（RD） , retinal vasculitis, pathogenic bacte- ria and so on. Results Multiple variable analysis showed that there is no statistically significant differences for sex, age, type of injury matter, VA, intraocular foreign body to prognosis. However, the factors significantly affecting prognosis of vitrectomied eyes of traumatic endophthaimitis were preoperative or intraoperative RD and retinal vaseulitis（ OR = 6. 78 ,χ^2 = 10. 07, P 〈 0. 01 ）. Besides, the species of intraocular pathogenic bacteria also significantly affected postoperative VA （ OR = 5.91 ,χ^2 = 9.99, P 〈 0. 05 ）. Conclusion Preoperative or intraoperative retinal damage, complexity of surgery and the species of intraocular pathogenic bacteria are closely related to the final vision in vitrectomied eyes of traumatic endophthalmitis.