外伤性眼内炎HA义眼座Ⅰ期植入临床观察

Clinical observation of evisceration and primary hydroxyapatite implantation in traumatic endophthalmitis.

目的 观察外伤性眼内炎羟基磷灰石 (HA)义眼座Ⅰ期植入的效果。方法 住院病例分析和随访观察。结果 2 0 0 0年因眼内炎眼内容摘除和HA义眼座Ⅰ期植入 10例。义眼座植入肌锥内或后部开孔的巩膜腔内。术后大剂量有效抗生素、皮质类固醇全身和局部应用 5～ 7天 ,加压包扎 3～ 5天。8例Ⅰ期愈合 ,随访至少 3月以上 ,未见并发症 ;另 2例术后 4天和 8天发现感染而取出义眼座 ,其中 1例术前眼眶或眶周化脓性炎症、1例为真菌感染。结论 外伤后非特异性化脓性眼内炎可行眼内容摘除HA义眼座Ⅰ期植入 ,而合并眶内和眶周感染、难以控制的细菌感染或真菌感染应慎重。

Objective To observe the clinical effect of evisceration and primary hydroxyaptite(HA) implants in traumatic endophthalmitis.Methods Analysing the inpatient medical history records and follow up observations.Results 10 cases were included in this series within the year 2000,and HA implants were implanted in muscle cone or scleral space.Antibiotics and corticosteroids were used for 5～7 days,and comppress wrapping for 3～5 days postoperatively.Healing by first intention and no complication were found in 8 cases during more than 3 month follow up.HA infection was found in 2 cases on fourth and eighth postoperative day,one with preoperative intraorbital infection,and another with preoperative fungi infection,and infected HA implants were removed in this two cases.Conclusion Primary HA implantation can be operated in endophthalmitis with non special infection.Secondary HA implantation should be taken on endophthalmitis with special infection or intraorbital and periorbital infection