白内障患者超声乳化术后感染性眼内炎危险因素及对策分析

Risk Factors and Countermeasures of Infective Endophthalmitis After Phacoemulsification

目的对白内障患者超声乳化术后感染性眼内炎危险因素进行分析,探讨有效的干预对策。方法回顾性分析2017年1月至2019年5月宝应县第二人民医院收治的白内障患者超声乳化术后感染性眼内炎的50例患者为研究对象,并纳入研究组,选取同期80例行超声乳化术未发生感染性眼内炎的患者为对照组,收集患者的一般资料、合并症及危险因素进行单因素及多因素分析,探讨有效的干预对策。结果50例感染性眼内炎患者,检出50株病原菌,其中革兰阳性菌47株,占94.00%,主要为表皮葡萄球菌40株、头状葡萄球菌2株、腐生葡萄球菌1株及粪肠球菌4株,真菌共3株,为白色假丝酵母菌,占6.00%;研究组年龄、合并糖尿病、手术切口类型、手术用时、玻璃体溢出及晶状体后囊破裂等因素与对照组比较,差异有统计学意义(P<0.05);两组性别、职业、合并高血压与高血脂及住院时间等因素对比,差异无统计学意义(P>0.05)。分析可知,白内障超声乳化术后发生感染性眼内炎的独立危险因素主要为:年龄、合并糖尿病、手术切口类型、手术用时、玻璃体溢出及晶状体后囊破裂等。结论白内障患者超声乳化术后感染性眼内炎发生主要为革兰阳性菌感染,导致其发生的危险因素较多,如60岁以上、合并糖尿病、手术切口过大、手术时间过长、玻璃体溢出及晶状体后囊破裂等,为预防及减少感染性眼内炎的发生,需要采取针对性的干预措施,做好围术期的护理,还需要配合正确的治疗方式,尽量使疾病在短时间内得到救治。

Objective The risk factors of infective endophthalmitis after phacoemulsification were analyzed to explore the effective intervention measures.Methods Retrospective selection between January 2017 to May 2019,the Baoying County Second People's Hospital phaco infectious endophthalmitis after cataract patients of 50 cases of patients as the research object,into the team,and in the same period,80 underwent phaco infectious endophthalmitis in patients as control group,to collect general information of patients,complications and risk factors of single factor and multiple factors analysis,to explore effective intervention measures.Results 50 strains of pathogenic bacteria were detected in 50 patients with infectious endophthalmitis,among which 47 strains were gram-positive,accounting for 94.00%.The main strains were 40 strains of Staphylococcus epidermidis,2 strains of Staphylococcus cephalis,1 strain of Saprophytic Staphylococcus and 4 strains of enterococcus faecalis.There were statistically significant differences between the study group and the control group in age,diabetes mellitus,type of surgical incision,duration of operation,vitreous overflow and posterior capsular rupture(P<0.05).There was no significant difference in gender,occupation,hypertension,hyperlipidemia and length of hospital stay between the two groups(P>0.05).The independent risk factors for infectious endophthalmitis after phacoemulsification were age,diabetes mellitus,type of incision,duration of operation,vitreous overflow and posterior capsular rupture.Conclusion Phaco infectious endophthalmitis after cataract patients occurred mainly gram-positive bacteria infection,leading to the occurrence of risk factors,such as more than 60 years of age,diabetes mellitus,excessive incision,operation time is too long,overflow and vitreous lens posterior capsular rupture and so on,in order to prevent and reduce the occurrence of infectious endophthalmitis,need to take corresponding intervention measures,do a good job in perioperative care,also need to match the right treatment,try to make the disease in a short period of time to get treatment.