玻璃体切除术联合抗菌药物治疗患者化脓性眼内炎的临床疗效研究

发布时间：2019-02-12 09:23

【摘要】：目的探讨玻璃体切除术联合抗菌药物治疗患者化脓性眼内炎的临床疗效。方法回顾性分析医院2008年6月-2016年6月经临床诊断为化脓性眼内炎患者78例(80眼)临床资料,78例患者在接受玻璃体切除术基础上采用联合抗菌药物治疗,术前取标本送细菌学检查,根据药敏试验结果选用敏感抗菌药物,观察患者手术前后视力、手术过程中不良反应情况、手术后患者预后情况。结果送检标本中,共检出135株病原菌,主要以金黄色葡萄球菌28株占20.74%、表皮葡萄球菌19株占14.07%、镰刀菌18株占13%最为常见;与术前相比,70例占89.74%患者视力改善,8例占10.25%患者视力无明显改善;在玻璃体切除联合抗菌药物治疗眼内炎过程中,不良反应事件发生9例,发生率为11.54%;通过对患者进行随访6-12月的随访记录,患者总有效67例,总有效率为85.90%。结论玻璃体切除术联合抗菌药物治疗化脓性眼内炎的疗效较好,安全性尚可,开展细菌培养及药敏试验结果有助于指导合理用药。
[Abstract]:Objective to investigate the clinical effect of vitrectomy combined with antibiotics in the treatment of suppurative endophthalmitis. Methods the clinical data of 78 patients (80 eyes) with suppurative endophthalmitis diagnosed from June 2008 to June 2016 in our hospital were retrospectively analyzed. 78 patients were treated with combined antimicrobial agents on the basis of vitrectomy. According to the results of drug sensitivity test, sensitive antimicrobial agents were selected to observe the visual acuity before and after operation, adverse reactions during operation, and the prognosis of patients after operation. Results 135 strains of pathogenic bacteria were detected, among which 28 strains were Staphylococcus aureus (20.74), 19 strains were Staphylococcus epidermidis (14.07%) and 18 strains were Fusarium (13%). The visual acuity of 70 cases (89.74%) and 8 cases (10.25%) were improved compared with those before operation. In the course of vitrectomy combined with antimicrobial agents in the treatment of endophthalmitis, adverse events occurred in 9 cases, the incidence rate was 11.54; Through the follow-up of 6-12 months, 67 cases were effective and the total effective rate was 85. 90%. Conclusion Vitrectomy combined with antimicrobial agents is effective and safe in the treatment of suppurative endophthalmitis. The results of bacterial culture and drug sensitivity test are helpful to guide the rational use of drugs.
【作者单位】：河北省眼科医院糖尿病眼科;
【分类号】：R779.6

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