31例儿童外伤感染性眼内炎病因及治疗效果分析

发布时间：2018-03-22 06:32

本文选题：儿童　切入点：外伤性眼内炎　出处：《中山大学学报(医学科学版)》2016年05期 　论文类型：期刊论文

【摘要】：【目的】分析总结儿童眼外伤感染性眼内炎的临床特点,探讨儿童眼内炎最佳治疗时间和方案。【方法】回顾性分析2012年11月至2014年8月在中山大学中山眼科中心作者诊治的儿童外伤性感染性眼内炎31例(31只眼)的临床资料,总结其临床特征和治疗方法。【结果】31例患儿,男性26例,女性5例,年龄1~12岁,平均年龄5.4岁,幼儿组4人、学龄前组13人、学龄组13人。根据患儿眼内炎的病变程度,分别选择静脉注射抗生素(4例)、玻璃体手术联合玻璃体腔注射抗生素(10例)、玻璃体手术联合眼内硅油填充(16例)和玻璃体手术联合眼内惰性气体填充(1例)等治疗方法。治疗效果:良好19例(61.29%),硅油依赖6例(19.35%);眼球萎缩或低眼压6例(19.35%)。本组儿童致伤原因较多,幼儿主要是家用锐器,学龄前及学龄儿童以学习用具为主。本组儿童眼内炎病原菌培养检出率低(37.04%)、耐药菌多,G+球菌是主要感染菌种(50%),存在复合菌种感染(10%)。头孢他啶静脉滴注联合左氧氟沙星局部频繁滴眼可有效控制细菌性感染,10 d内接受玻璃体手术治疗的预后优于10 d后接受手术治疗(P0.05),使用抗生素药物的早与晚均不影响患者预后(P0.05)。【结论】早期玻璃体手术是决定儿童眼内炎预后的关键,玻璃体手术联合硅油填充是挽救重度眼内炎最有效的措施。
[Abstract]:[Objective] to analyze the clinical characteristics of children's eyes sad infectious endophthalmitis, to explore the best treatment time and endophthalmitis in children. [Methods] a retrospective analysis from November 2012 to August 2014 in Ophthalmological Center of Zhongshan University for diagnosis and treatment of traumatic infectious ocular inflammation in 31 cases (31 eyes) of the clinical data, summarize the clinical features and treatment methods. [results] 31 cases, male 26 cases, female 5 cases, age 1~12 years old, the average age of 5.4 years, 4 preschool children group, group 13, in group 13. According to the severity in children with endophthalmitis were selected, intravenous antibiotics (4 cases), vitreous body surgery and intravitreal injection of antibiotics (10 cases), vitreous body surgery combined with silicone oil tamponade (16 cases) and intraocular surgery combined with vitreous body filled with inert gas (1 cases) and other treatment methods. Good therapeutic effect: 19 cases (61.29%), 6 cases of silicone oil dependent (19.35%); ocular atrophy or low intraocular pressure in 6 cases (19.35%). This group of children injuries caused by many reasons, the children mainly are household sharps, preschool and school-age children with learning tools. The low positive rate of the pathogen of endophthalmitis in children (37.04%), drug-resistant bacteria, G+ bacteria is the main pathogen (50%), there are (10%). Composite bacterial infection of ceftazidime intravenous infusion combined with levofloxacin eye drops can effectively control the local frequent bacterial infection, the prognosis is better than 10 d after 10 d accepted surgical treatment of vitreous body surgery (P0.05), the use of antibiotics in early and late did not affect the prognosis of patients (P0.05). [Conclusion] early surgery is the key to vitreous body prognosis of endophthalmitis in children, vitreous body surgery combined with silicone oil filling is the most effective measures to rescue severe endophthalmitis.

【作者单位】：中山大学中山眼科中心//眼科学国家重点实验室;
【基金】：广东省科技计划项目(303090100502017)
【分类号】：R779.1

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