摘要
目的 分析白内障术后感染性眼内炎的临床表现及致病菌.方法 对2013年1月~2016年12月白内障术后感染性眼内炎87例的临床资料进行回顾性分析.结果 白内障术后眼内炎发生率为0.21%,受年龄、白内障类型、是否合并其他眼部疾病和全身疾病等因素影响.87例中有84例为急性眼内炎,发病时间为术后1~30 d,平均为（6.57±6.83）d,术后10 d内发病者最多.细菌培养阳性率为39.44%,玻璃体培养阳性率最高为45.83%.致病菌中75.00%为葡萄球菌属细菌,对万古霉素、利奈唑胺及利福平敏感性较高,对大环内酯类药物的敏感率较低,对其他药物的敏感性30.00%~75.00%.71例（81.61%）经玻璃体手术和（或）玻璃体内注射抗菌药物治疗后,炎症得到控制,视力有所恢复.结论 白内障术后眼内炎发病的影响因素很多,且多数为急性发作,尽早的标本送检对明确致病菌指导药物治疗具有重要的意义,而玻璃体手术和（或）玻璃体注药术是控制眼内炎,改善预后的关键.
Objective To analyze the clinical feature and pathogenic bacteria of infectious endophthalmitis after cataract surgery .Methods The data of 87 cases with infectious endophthalmitis after cataract surgery from Jan.2013 to Dec.2016 were collected and analyzed retrospectively .Results The rate of endophthalmitis after cataract surgery was 0.21%, which was affected by age,type of cataract, whether combined with other ocular diseases and systemic diseases . Of the 87 cases, 84 cases were acute endophthalmitis.The onset time of the disease was 1-30 days after surgery,average （6.57 ±6.83） days, and the peak period of the disease was 10 days after operation .The positive rate of bacterial culture was 39.44%, of which the highest positive rate bacterial culture in vitreous was 45.83%.Staphylococcus epidermidis occupyed for 75.00%, it was sensitive to Vancomycin , Linezolid and Rifampin, low sensitive to Macrolides, and sensitivity to other drugs ranged from 30.00% to 75.00%.The endophthalmitis of 71 patients（81.61%） were controlled after vitrectomy and /or intravitreal injections of antibiotics , and the vision was restored .Conclusion There are many risk factors associated infectious endophthalmitis after cataract surgery ,and most of them are acute episodes .As soon as possible to clear the specimen of pathogenic bacteria has important significance to guide drug therapy .The vitrectomy and /or intravitreal injections of antibiotics are key factors to control endophthalmitis and improve the prognosis .
作者
王娟
陈梦平
张慧芝
李乐
罗世伟
张晓燕
王焕
Wang J;Zhang HZ;Zhang XY;Wang H;Chen MP;Li L;Luo SW(Department of Pharmacy;Department of Ophthalmology;Department of Clinical Laboratory , The Affiliated Zhengzhou Second People＇ s Hospital of Ji＇ nan University, Zhengzhou, 450006 , China)
出处
《中华眼外伤职业眼病杂志》
2017年第12期914-918,共5页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
白内障
眼内炎
感染性
致病菌
药敏试验
Cataract
Endophthalmitis, infectious
Pathogenic bacteria
Microbial sensitivity tests
