59例感染性眼内炎的临床分析

发布时间：2018-05-08 12:16

本文选题：眼内炎 + 眼外伤　；参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：通过对我院眼科近两年的眼内炎病例的回顾性总结,分析其发生的特点、细菌培养结果、治疗及预后情况。方法：回顾性系列病例研究。收集2012年8月至2014年11月在新疆医科大学第一附属医院住院治疗的眼内炎共59例60眼,对感染性眼内炎致病原因及构成比、外伤后眼内炎患者人群特点、病原菌培养结果、治疗情况及预后进行分析总结。数据分析采用SPSS 19.0统计学软件,对内、外源性眼内炎两组间正态分布连续变量资料,采用近似t检验、卡方检验,用二项logistic回归分析影响眼内炎预后的危险因素；P0.05作为差异显著性标准。结果：眼内炎致病原因及构成比显示外伤后眼内炎45例45眼,占同76.3%。术后眼内炎9例9眼,占15.2%。内源性眼5例6眼,占8.5%。外伤后眼内炎患者人群特点,初中及以下文化28例(62.2%),初中以上至大专13例(28.9%),大学及以上4例(8.9%)。工人23例(51.1%),农民15例(33.3%),学龄前及学生5例(11.1%),职员2例(4.4%)。从有症状出现到确诊和治疗的时间间隔：外源性：1-27d,平均4.52d;内源性眼：4-45d,平均为24.53d。采用完全随机设计两均数比较的近似t检验,差异有统计学意义(P0.05)。59例60眼玻璃体/房水标本病原菌培养,培养阳性标本4眼,其阳性率为6.7%。9例未行PPV治疗就得以治愈的患者,POE患者8例,PTE患者2例,经连续校正卡方检验得出药物治疗有效率有统计学差异(χ2=30.068,P=0)。所有眼内炎治疗后最佳矫正视力大于0.05者15例15眼,与治疗前相比有统计学意义(χ2=7.669,P=0.006),治疗效果明显,但仍有41例41眼矫正视力在0.05以下,占73.2%,总体预后不佳。对治疗后BCVA低于0.05的有关危险因素,分析结果显示,年龄、就诊时间、眼内异物和术前视力因素被认为是与眼内炎患者视力预后的危险因素。结论：感染性眼内炎中,外源性眼内炎发病率较高,其中眼外伤是主要的致病因素。在外伤后眼内炎中,男性的患病率较女性的患病率高；从事建筑工人、机械制造工人及农民等文化程度较低的人群发病率高。内源性眼内炎的发病至就诊耗时比外源性眼内炎的平均耗时长。眼内炎标本培养总体阳性率6.7%,远远低于与文献报道29.8%-63%。玻璃体腔注药联合抗菌素治疗术后眼内炎患者较外伤后眼内炎患者成功率较高。治疗后最佳矫正视力好于治疗前。但从结果明显看出,尽管治疗后效果好于治疗前,但依然有41例41眼矫正视力在0.05以下,占73.2%,说明虽然治疗有效,但总体预后不佳。年龄、就诊时间、眼内异物和术前视力等因素被认为是与眼内炎患者视力预后的危险因素。
[Abstract]:Objective : To summarize and analyze the clinical features , results , treatment and prognosis of endophthalmitis in the first Affiliated Hospital of Xinjiang Medical University from August 2012 to November 2014 . Methods : The data of 59 cases of endophthalmitis hospitalized in the First Affiliated Hospital of Xinjiang Medical University from August 2012 to November 2014 were analyzed and summarized .
Results : There were 45 cases ( 51.1 % ) , 15 cases ( 33.3 % ) , 5 cases ( 11.1 % ) of workers , 15 cases ( 33.3 % ) , 5 cases ( 11.1 % ) in secondary school and 4 cases ( 8.9 % ) . The best corrected visual acuity was more than 0.05 in all eyes in 15 cases ( 蠂2 = 7.669 , P = 0.006 ) . The results showed that the incidence of postoperative BCVA was lower than 0.05 . The results showed that the incidence of postoperative BCVA was lower than 0.05 . Conclusion : In infective endophthalmitis , the incidence of exogenous endophthalmitis was higher , and the ocular trauma was the main risk factor . In the post - traumatic endophthalmitis , the prevalence of male was higher than that of women .
The incidence of endogenous endophthalmitis was significantly lower than that in patients with endophthalmitis . The overall positive rate was 6.7 % , which was significantly lower than that reported in the literature .

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R771

【参考文献】