白内障超声乳化摘除联合人工晶状体植入术后感染性眼内炎的相关因素分析

Analysis of related factors of infective endophthalmitis after phacoemulsification combined with intraocular lens implantation

目的分析白内障超声乳化(PHACO)联合人工晶状体(IOL)植入术后感染性眼内炎的相关危险因素。方法选取2013年2月-2020年3月在本院接受PHACO+IOL植入术治疗的1200例(1200眼)患者作为研究对象。收集患者术后感染性眼内炎发生情况等相关指标,分析导致感染性眼内炎发生的相关危险因素。结果感染性眼内炎发生率为0.25%(3/1200),经及时有效治疗后获得良好控制,无其他严重感染;单因素分析结果显示,伴有糖尿病、接受复杂手术、滤过手术、手术切口>3.20mm、时间≥30min、前房未注药、植入PMMA是患者术后感染性眼内炎发生的危险因素(χ^(2)=6.880、4.380、5.036、5.494、5.036、6.200、12.782,均P<0.05);多因素分析结果显示,伴有糖尿病、复杂手术、手术切口大、手术时间长、前房未注药、滤过手术、用PMMA均是导致PHACO+IOL植入术患者发生感染性眼内炎的独立危险因素(OR值=0.387、0.414、0.188、0.429、0.510、2.374、1.542,均P<0.05)。结论伴有糖尿病、复杂手术、手术切口大、手术时间长、前房未注药、滤过手术、用PMMA均是导致PHACO+IOL植入术患者发生感染性眼内炎的独立危险因素。

Objetive To analyze the risk factors of infectious endophthalmitis after phaco and IOL implantation.Methods 1200 patients(1200 eyes)who received phaco+IOL implantation in our hospital from February 2013 to March 2020 were selected as the research objects.The incidence of postoperative infectious endophthalmitis and other related indicators were collected,and the related risk factors leading to the occurrence of infectious endophthalmitis were analyzed.Results The incidence of infective endophthalmitis was 0.25%(3/1200).After timely and effective treatment,it was well controlled without other serious infection;Univariate analysis showed that diabetes mellitus,complicated surgery,filtration surgery,incision>3.20 mm,time≥30 min,no drug injection in anterior chamber and implantation of PMMA were the risk factors of postoperative infectious endophthalmitis(χ^(2)=6.880,4.380,5.036,5.494,5.036,6.200,12.782,all P<0.05);Multivariate analysis showed that diabetes mellitus,complicated surgery,large incision,long operation time,no drug injection in anterior chamber,filtration surgery and PMMA were the independent risk factors of infectious endophthalmitis in patients with phaco+IOL implantation(OR值=0.387,0.414,0.188,0.429,0.510,2.374,1.542,all P<0.05).Conclusion Diabetes mellitus,complicated surgery,large incision,long operation time,no drug injection in anterior chamber,filtration surgery and PMMA were the independent risk factors of infectious endophthalmitis in patients with phaco+IOL implantation.