摘要
目的探讨慢性闭角型青光眼术后滤过泡感染相关性眼内炎危险因素、临床表现及治疗方法,以挽救患者的视力。方法回顾性分析2008年1月-2013年1月医院行青光眼滤过手术的1 342例慢性闭角型青光眼患者临床资料,对术后发生滤过泡感染相关性眼内炎进行分析,将其按照单纯滤过泡感染和滤过泡相关性眼内炎进行分组,对两组患者滤过泡表面的分泌物质、房水或玻璃体抽取物送检验科进行病原菌培养;所有患者均进行对症支持治疗及应用抗菌药物,比较两组患者治疗后眼压;所有数据采用SPSS19.0软件进行统计分析。结果发生的术后滤过泡感染相关性眼内炎共31例,感染率2.31%;术中放置丝裂霉素的患者发生感染24例,感染率为3.44%,未放置丝裂霉素患者发生感染7例,感染率为1.09%,两组感染率差异有统计学意义(P<0.05);单纯性滤过泡感染组与滤过泡眼内炎组患者检出革兰阳性菌和革兰阴性菌分别为41.18%和47.06%与64.28%和35.71%,差异无统计学意义;单纯滤过泡感染与滤过泡眼内炎患者经治疗后眼压比较,差异无统计学意义。结论慢性闭角型青光眼术后患者会发生滤过泡相关性眼内炎和滤过泡感染,发病急骤、进展迅速,手术中使用抗代谢药物会提高滤过泡功能化率,但与发生感染密切相关,因此临床上要谨慎应用,患者经过合理治疗后可以在一定程度上挽救患者视力。
OBJECTIVE To explore the risk factors for postoperative filtering blebs infection-associated endophthalmitis in patients after chronic angle-closure glaucoma surgery and analyze the clinical manifestations so as to save the patient＇s visual acuity. METHODS The clinical data of 1342 patients with chronic angle-closure glaucoma who underwent glaucoma filtration surgery from Jan 2008 to Jan 2013 were retrospectively analyzed, then the risk factors for the postoperative filtering blebs infection-associated endophthalmitis were analyzed, the patients were grouped according to the simple bleb infection and the filtering blebs infection-associated endophthalmitis, the secretions, aqueous humor or vitreous body abstractions were sampled and submitted to the clinical laboratory for culture of pathogens% all the patients were given the symptomatic treatment and antibiotics therapy, the intraoeular pressure was compared between the two groups, and the statistical analysis of all the data was performed with the use of SPSS19. 0 software. RESULTS The postoperative filtering blebs infection-associated endophthalmitis occurred in 31 cases with the infection rate of 2. 31%, including 24 （3. 44%） patients with intraoperative mitomycin placement and 7 （1.09%） patients without mitomycin placement, the difference in the infection rate between the two groups was statistically significant （P〈 0. 05）. The gram-positive bacteria isolated from the patients with simple filtering blebs infections accounted for 41. 18%, 47.06% from the patients with filtering blebs endophthalmitis; the gram-negative bacteria isolated from the patients with simple filtering blebs infections accounted for 64.28%, 35.71 % from the patients with filtering blebs endophthalmitis, the difference was statistically insignificant% the difference in the postoperative intraocular pressure between the simple filtering blebs infections patients and the filtering blebs endophthalmitis was not statistically significant. CONCLUSION The filtering blebs infect
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第6期1501-1503,共3页
Chinese Journal of Nosocomiology
基金
甘肃省中医药科研基金资助项目(GZK-2011-51)
关键词
青光眼
慢性闭角型青光眼术
滤过泡感染
相关性眼内炎
Glaucoma
Chronic angle-closure glaucoma surgery
Filtering blebs infection
Associated endophthalmitis
