169例感染性眼内炎病因分析

Etiological Analysis on 169 cases of infective endophthalmitis

目的 探讨感染性眼内炎的致病原因和危险因素。方法 对我院 1996年 10月～ 2 0 0 2年 10月连续治疗的 169例感染性眼内炎患者的临床资料进行回顾性分析。内容包括发病原因、年龄、病程、治疗和预后情况。结果 致病因素 :外伤 13 6例 13 6只眼 ,内眼手术 11例 11只眼 ,转移性 17例 18只眼 ,暴露性角膜炎角膜穿孔 5例 5只眼。 10 4例 10 5只眼行玻璃体切割手术 ,2 7例 2 7只眼行眼球摘除或眼球内容物剜出 ,2 3例 2 3只眼行缝合伤口或外路异物取出加药物治疗 ,12例 12只眼单纯行药物治疗 ,5例 5只眼放弃玻璃体切割而自动出院。治疗结果 :视力无光感 13只眼 ,光感 3 4只眼 ,手动 3 6只眼 ,数指 2 2只眼 ,0 0 2～ 0 19只眼 ,0 1～ 0 2 5只眼 ,0 2～ 0 3 3只眼 ,0 3～ 0 45只眼 ,0 4～ 0 5 3只眼 ,0 5～ 0 63只眼 ,0 81只眼 ,因患儿年幼不认识视力 8只眼 ,2 7例单眼无眼球。随访 1月～ 60个月 ,平均 9月 ,68只眼球萎缩。结论 眼外伤是感染性眼内炎的主要致病因素 ,重在预防。随着玻璃体切割手术和球内注射抗生素的应用 ,感染性眼内炎的预后有所改善。但早期诊断、及时有效的治疗是保存患眼 ,挽救视力的关键。

Objective To study the causes and risk factors of infectivet endophthalmitis.Methods 169 consecutive patients with infective endophthalmitis were analyzed retrospectively,including the etiological factors,age,clinical phage,therapy and prognosis.Results The etiological factors include ocular trauma in 136 eyes,surgery in 11 eyes,endogenous endophthalmitis in 18eyes and exophthalmic keratitis in 5 eyes.104 patients were treated with vitrectomy,27 patients had eyeball removal or enucleation,23 patients were performed suture or intraocular foreign body extraction from sclera,12 patients were only treated by medicine and 5 patients discharged without enough money.Only 29 eyes had vition better than 0.02 at discharge.During the one month to five years′ following up,68 eyes were atrophy.Conclusions Ocular trauma is the main reason of infective endophthalmitis.Prognosis has improved since vitrectomy and intravitreal antibiotics were used.To diagnose and treat in time is the key to save the eyeball and vision.