29例感染性眼内炎患者病因及临床治疗效果分析

摘要

Objective To analyze the etiology and treatment outcome in 29 patients(29 eyes) with infectious en-dophthalmitis.Methods This retrospective study reviewed medical records of 29 patients (29 eyes) treated in Anhui Pro-vincial Hospital from January 2013 to June 2014.Causes and treatment outcomes were analyzed.Results The major cau-ses of infectious endophthalmitis were intraocular surgery (55.2%) and ocular trauma (37.9%).Pathogens were identi-fied in 24.1%of the cases and most common bacteria were Gram-positive cocci, particularly Staphylococci.Seven patients received anterior chamber irrigation combined with intravitreal injection, 6 patients underwent simple intravitreal injection, and 15 patients received vitreous-retinal surgery.There were 3 patients who received evisceration surgery, among whom two were due to uncontrolled infection.The overall rate of eye preservation was 93.1%.Mean best corrected visual acuity was 2.8 ±1.4, which was significantly better than preoperative (1.6 ±1.0) visual acuity ( t =-6.6, P <0.01).Conclu-sion The major causes of infectious endophthalmitis are ocular trauma and intraocular surgery.The most common bacteria are Gram-positive cocci.Appropriate treatment regimen is important to control inflammation and to save visual function.%目的：探讨感染性眼内炎患者的致病因素和临床治疗效果。方法回顾性分析安徽省立医院2013年1月至2014年6月收治的29例（29只眼）感染性眼内炎患者，分析其致病原因、治疗方法和治疗效果。结果29例感染性眼内炎患者主要致病原因是内眼手术（55．2％）和眼外伤（37．9％）；病原体检出率为24．1％，主要致病菌是革兰阳性球菌，以表皮葡萄球菌为多见；7只眼行前房冲洗联合玻璃体腔注药术，6只眼行单纯玻璃体腔注药术，15只眼行玻璃体视网膜联合手术，1只眼行眼内容剜除术，治疗结束共2只眼因感染无法控制而行眼内容剜除术，眼球保存率93．1％，术后平均最佳矫正视力为2．8±1．4，较术前明显提高（1．6±1．0），有统计学意义（ t ＝-6.6， P ＜0．01）。结论感染性眼内炎常见的致病因素有眼外伤和内眼手术，常见的病原体为革兰阳性球菌，治疗上根据眼内炎的严重程度而采用合适的治疗方案，是控制炎症，挽救视功能的有效措施。