细小眼球穿孔伤致眼内炎的临床分析

The clinical analysis of endophthalmitis caused by minor ocular perforation

目的 探讨眼球细小穿孔伤致眼内炎的发生率及其原因。方法 对 15 3例眼球细小穿孔伤致眼内炎患者的临床资料 ,包括致伤物种类、伤口大小、眼内异物存留、相伴组织损伤、早期视功能情况、感染发生速度、微生物检查结果及治疗转归等进行分析。结果 细小眼球穿孔伤致眼内炎的发生率为 4 2 3%。随访 3个月至 7年 ,15 3例患者中视力 >0 3者 13例 ,占 8 5 % ;视力≤ 0 3者 14 0例 ,占 91 5 % ;其中眼球摘除者 37只眼 ,占 2 4 2 %。结论 眼球细小穿孔伤后一旦发生感染 ,4～ 12h内患者的视功能可受到严重损害。应早期预见眼内炎的危险并及时诊断和治疗。

Objective To discuss the incidence rate and causes of endophthalmitis caused by minor ocular perforation. To document its damage to the visual function, so as to improve the rate of prevention of this disease. Methods The following clinical information of 153 cases with minor ocular perforations from a retrospective study was collected: general conditions, injury objects, wound shape and size, presence or absence of ocular foreign body, associated organic injuries, visual functions in the early stage after injury, speed of occurrence of infection, and positive rate of microbiological tests. The results with the drug treatments and surgical therapy were analyzed. Results All of 153 cases were followed up from 3 months to 7 years. The visual acuity in 13 cases (8.5%) was over 0.3. 140 cases (91.5%) were less than 0.3. Enucleating was performed in 37 cases (24.2%). Conclusion The patients with minor ocular perforations tend to have good visual acuity in the early stage after injury. But their visual acuity was lost in 4 to 12 hours if rapid and severe infections occurred. The risk of endophthalmitis should be recognized and evaluated on time in the early stage after injury.