31例感染性眼内炎的临床分析与治疗

Clinical analysis and treatment of 31 cases of patients with infectious endophthalmitis

目的分析感染性眼内炎的病因构成、病原学检查及治疗的临床效果。方法对感染性眼内炎患者31例31眼的临床资料进行回顾性分析。外伤感染18例18眼(异物伤13例,利器穿通伤5例);白内障手术后感染9例9眼;角膜移植术后感染1例1眼;角膜葡萄肿致眼球破裂感染2例2眼;角膜溃疡感染1例1眼。结果 23例行玻璃体取样培养,12例检出病原体,培养阳性率为52.2%。经治疗后,视力提高17眼(55.5%),视力无改善4眼(12.9%),视力下降1眼(3.2%),眼内容物剜除5眼(16.1%),2例转院后无随访,1例白内障术后经保守治疗仍无光感者自动放弃治疗出院后无随访,1例手术前后均无法配合检查视力。结论眼外伤和白内障手术是目前导致感染性眼内炎的主要原因,尽早行玻璃体注药或联合玻璃体切割术是治疗眼内炎的有效方法。

Objective To analyze the causes, pathogenic bacterium and result of treatment of infectious endophthalmitis. Methods The data of 31 patients with infectious endophthalmitis were respectively analyzed. The most common pathogenic factor of the infectious endophthalmitis was ocular trauma （18 cases, foreign bodies wound： 13 cases, syringe： 5 cases）; endophthalmitis caused by cataract surgery were 9 cases; corneal graft infection was 1 case; corneal staphyloma caused by the eyeball rupture infection was 2 cases; corneal ulcer infections was 1 case. Results 23 cases of vitreous sampling cul- ture, 12 cases of detection of pathogens, the positive rate of the cultivation were 52.2%. After treatment, postoperative visual acuity improved in 17 patients （55.5%）, 4 eases （12.9%） with no improvement, 1 case （3.2%） with decrease, 5 cases with eye global removed, 2 eases transferred without follow-up, 1 case after cataract surgery with conservative treatment still no light perception to give up treatment after discharge follow-up, 1 case was unable to cooperate with visual acuity before and after surgery. Conclusion Ocular trauma and cataract surgery arc the main causes of infectious endophthalmitis. Vit- rectomy is an effective method for the treatment of endophthalmitis, should be performed as early as possible.