白内障患者术后眼内感染因素与临床治疗研究

To investigate the infection factors and clinic treatment of endophthalmitis after cataract surgery

目的探讨白内障术后眼内感染的因素,并研究治疗的方法,为临床预防和治疗白内障术后眼内感染提供参考依据。方法选取2012年1月-2014年1月眼科收治的25例(25只眼)白内障术后眼内感染患者,抽取感染患者的房水及玻璃体,然后对其进行病原学检查;所有感染患者给予全身和局部广谱抗菌药物及少量糖皮质激素治疗,同时依据药敏结果选择敏感药物。结果 40 000例完成白内障摘除人工晶体植入术的患者中25例(25只眼)术后发生眼内感染,感染率为0.06%;白内障术后眼内感染的因素为结膜囊污染、后囊破裂、并发糖尿病、外伤、恶性肿瘤;25例感染患者治疗后9例患者治愈,治愈率36.00%;9例患者治疗有效,有效率36.00%,总有效率达72.00%。结论白内障术后眼内感染因素包括糖尿病、眼外伤、恶性肿瘤等,治疗方法主要有玻璃体手术及规范用药。

OBJECTIVE To investigate the infection factors of endophthalmitis after cataract surgery ,and to study the therapeutic methods ,so as to provide basis for clinical prevention and treatment .METHODS Totally 25 cases （25 eyes） of patients with endophthalmitis after cataract surgery from Jan .2012 to Jan .2014 in the department of ophthalmology were chosen and their aqueous fluid and vitreous body were treated with pathogenic inspection .All the patients were given systemic and topical antibiotics and a small amount of glucocorticoids ,at the same time , sensitive drugs were chosen according to the results of drug susceptibility .RESULTS A total of 25 cases （25 eyes） were infected in the 40 000 patients who had adopted the cataract extraction and intraocular lens implantation and the infection rate was 0 .06% .And intraocular infection factors were conjunctival sac pollution ,posterior capsule rupture ,trauma ,diabetes mellitus ,and malignant tumor;9 patients who had received conservative treatment and were cured and the recovery rate was 36 .00% .Totally 9 patients had effective treatment and the effective rate was 39 .00% .The total effective rate reached to 72 .00% .CONCLUSION The infection factors of endophthalmitis after cataract surgery include diabetes ,ocular trauma ,and malignancy .Vitreous operation and standardized medication can be helpful in curing it .