玻璃体切割术治疗眼内炎疗效分析

发布时间：2018-02-12 16:09

本文关键词： 玻璃体切割眼内炎硅油　出处：《吉林大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的探讨玻璃体切割术治疗眼内炎的临床疗效。方法对我院2001年1月~2010年1月收治的眼内炎患者共51例51眼进行回顾性分析,右眼27眼,左眼24眼。男40例,女11例,男女比例为3.64:1,年龄5～61岁,平均38.6岁,51例患者均行玻璃体切割术,随访4～36个月,平均24.1个月。分析眼内炎的病因,并观察玻璃体切除术后视力变化和并发症。结果因眼球穿通伤所致眼内炎49例,是导致眼内炎的最主要原因,占本组病例的96.1%,5～8岁儿童组9例,占眼球穿通伤18.4%。内源性眼内炎2例。经玻璃体切割术联合全身及局部应用药物治疗后视力均有不同程度提高,提高率78.0%。19例玻璃体病原体涂片阳性,检出率37.3%,培养结果阳性21例,检出率41.2%。G+菌对万古霉素敏感率100.0%,对氧氟沙星敏感率80.0%,G-对头孢他定敏感率66.7%,氟康唑对真菌普遍有较强的抑制作用。随访4～36个月,术后并发症有前房炎性渗出、术后短暂高眼压,术后0.5～1个月玻璃体积血,2眼在术后4～5个月内发生视网膜脱离,2眼4～6个月白内障。手术在2天内与2～5天及大于5天之间治疗效果比较有差异,以2天内行玻璃体手术脱盲率为最高。结论(1)眼球穿通伤是导致眼内炎的最主要原因。(2)细菌性眼内炎的最常见的致病菌是革兰氏阳性菌。(3)在本组检出的病例中,G+菌对万古霉素敏感率100.0%,G-菌对头孢他定敏感率66.7%,氟康唑对真菌普遍有较强的抑制作用。(4)玻璃体切割术是治疗眼内炎的有效手段。(5)手术疗效与手术时间明显相关。
[Abstract]:Objective to investigate the clinical effect of vitrectomy in the treatment of endophthalmitis. Methods 51 cases (51 eyes) of endophthalmitis treated in our hospital from January 2001 to January 2010 were retrospectively analyzed. There were 27 eyes in right eye and 24 eyes in left eye. The ratio of male to female was 3.64: 1. The average age was 38.6 years old. Vitrectomy was performed in 51 patients with endophthalmitis. The follow-up period was 4 ~ 36 months (mean 24.1 months). The etiology of endophthalmitis was analyzed. Results 49 cases of endophthalmitis caused by penetrating injury of the eyeball were the main cause of endophthalmitis. The visual acuity was improved in varying degrees after vitrectomy combined with systemic and local drug therapy, the improvement rate was 78.0% and 19 cases were positive for vitreous pathogen smears, the detection rate was 37.3%, and the results of culture were positive in 21 cases. The sensitivity to vancomycin was 100.0, the sensitivity to ofloxacin was 80.0. The sensitivity rate of fluconazole to ceftazidine was 66.7. Fluconazole had a strong inhibitory effect on fungi. Follow-up for 4 ~ 36 months showed that the postoperative complications were anterior chamber inflammatory exudation and transient intraocular pressure. Vitreous hemorrhage occurred in 2 eyes with retinal detachment within 4 ~ 5 months after operation for 4 ~ 6 months. There was a significant difference in the therapeutic effect between 2 days and 2 days and more than 5 days. The most common pathogenic bacteria of bacterial endophthalmitis is Gram-positive bacteria. 3) in this group, the most common cause of endophthalmitis is Gram-positive bacteria (Gram-positive bacteria. 3) in this group, the most common cause of endophthalmitis is Gram-positive bacteria (Gram-positive bacillus). [conclusion] the most common cause of endophthalmitis is the penetrating injury of the eyeball, which is the most common cause of endophthalmitis. The sensitivity rate of bacteria to vancomycin was 100.0%. The sensitivity rate of fluconazole to ceftazidine was 66.7%. Fluconazole had a strong inhibitory effect on fungi. 4) vitrectomy was an effective method for the treatment of endophthalmitis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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