32例感染性眼内炎病因分析及早期诊疗思路探讨

发布时间：2018-05-11 05:26

本文选题：感染性眼内炎 + 早期诊断　；参考：《中国中医眼科杂志》2016年03期

【摘要】：目的探讨感染性眼内炎的早期诊疗思路。方法回顾性临床研究。收集2012年8月至2015年8月在我院眼科住院诊治的32例32眼感染性眼内炎患者的临床资料,回顾分析其临床特点及治疗结果。结果 32例患者均存在易感危险因素,其中19例为外源性眼内炎,13例为内源性眼内炎。24例有明确致病菌,其中真菌感染3例(3眼),细菌感染21例(21眼);另有8例致病菌不明。房水涂片的阳性率15.62%,房水培养的阳性率12.50%,玻璃体涂片的阳性率43.75%,玻璃体培养的阳性率65.62%。6例接受玻璃体注射抗菌素,17例接受玻璃体切割手术,9例接受眼球内容物剜除手术。随访3个月后,除9例眼球摘除外,其余23例患者眼内感染均得到控制,视力不同程度提高,其中8例视力0.3,15例视力为0.05~0.3。结论感染性眼内炎的早期诊疗要与患者易感因素密切结合,采用玻璃体切割方法取材可以明显提高玻璃体培养的阳性率,早期玻璃体注射抗生素可有效控制眼内感染,改善感染性眼内炎的预后。
[Abstract]:Objective to explore the early diagnosis and treatment of infective endophthalmitis. Methods retrospective clinical study. The clinical data of 32 patients with 32 eyes of infective endophthalmitis who were hospitalized in our hospital from August 2012 to August 2015 were analyzed retrospectively. Results all the 32 patients had predisposing risk factors, of which 19 cases were exogenous endophthalmitis, 13 cases were endogenous endophthalmitis. 24 cases had definite pathogenic bacteria, including 3 cases of fungal infection, 21 cases of bacterial infection, and 8 cases of unknown pathogens. The positive rate of aqueous humor smear was 15.62%, the positive rate of aqueous humor culture was 12.50, the positive rate of vitreous smear was 43.75, and the positive rate of vitreous culture was 65.62.6 cases. 17 cases received vitrectomy and 9 cases underwent vitrectomy. After 3 months follow-up, the intraocular infection was controlled and the visual acuity was improved to varying degrees in 23 cases except 9 cases of eyeball extirpation. The visual acuity of 8 cases was 0. 05 卤0. 3. Conclusion the early diagnosis and treatment of infective endophthalmitis should be closely combined with the susceptible factors of patients. Vitrectomy can obviously improve the positive rate of vitreous culture, and early vitreous injection of antibiotics can effectively control intraocular infection. To improve the prognosis of infectious endophthalmitis.
【作者单位】：山西大医院眼科;
【分类号】：R771

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