PACG合并白内障患者Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎的条件Logistic回归分析

Conditional Logistic Regression Analysis of Infectious Endophthalmitis after Phaco+IOL Implantation Combined with Trabeculectomy in PACG Patients with Cataract

目的:分析原发性闭角型青光眼(PACG)合并白内障患者使用Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎的相关危险因素。方法:回顾性分析2017年10月-2020年10月钟祥市人民医院2 061例接受Phaco+IOL植入术联合小梁切除术治疗的PACG合并白内障患者的临床资料,患眼2 984眼。根据术后是否并发感染性眼内炎分为感染组(72例,105眼)和非感染组(1 989例,2 879眼)。对两组患者临床资料进行单因素比较,选取差异有统计学意义的指标进行条件Logistic回归分析。结果:两组年龄、糖尿病、病房类型、眼外伤、眼部手术史、植入物类型、术后佩戴角膜接触镜情况比较,差异均有统计学意义(P<0.05)。经条件Logistic回归分析可知,高龄、眼外伤、入住日间病房、术后佩戴角膜接触镜均为PACG合并白内障患者术后并发感染性眼内炎的独立危险因素(P<0.05)。结论:PACG合并白内障患者经Phaco+IOL植入术联合小梁切除术后并发感染性眼内炎受高龄、眼外伤、入住日间病房、术后佩戴角膜接触镜等独立因素影响,临床需在手术前后针对以上因素给予预防措施避免患者术后并发感染性眼内炎。

Objective:To analyze the related risk factors of infectious endophthalmitis after Phaco+IOL implantation combined with trabeculectomy in primary angle-closure glaucoma (PACG) patients with cataract.Method:The clinical data of 2 061 PACG patients with cataract who received Phaco+IOL implantation combined with trabeculectomy in Zhongxiang People’s Hospital from October 2017 to October 2020 were retrospectively analyzed,2 984 eyes were affected.The patients were divided into the infection group (72 cases,105 eyes) and the non-infection group (1 989 cases,2 879 eyes) according to the complications of postoperative infectious endophthalmitis.The clinical data of the two groups were compared by single factor,and the significant difference indexes were selected for conditional Logistic regression analysis.Result:There were statistically significant differences in age,diabetes,ward type,ocular trauma,history of ophthalmic surgery,implant type and postoperative corneal contact lens wearing between two groups (P<0.05).According to the conditional Logistic regression analysis,the elderly,ocular trauma,day ward and postoperative corneal contact lens wearing were all independent risk factors for postoperative infectious endophthalmitis in PACG patients with cataract (P<0.05).Conclusion:In PACG patients with cataract after Phaco + IOL implantation combined with trabeculectomy,the old age,ocular trauma,day ward,and postoperative corneal contact lens wearing are independent factors of infectious endophthalmitis.In clinical practice,preventive measures should be taken to avoid postoperative infectious endophthalmitis according to the above factors before and after surgery.