感染性眼内炎282例临床分析

目的 分析感染性眼内炎的病因和病原学特征，提高感染性眼内炎的认知和临床诊治水平。方法 回顾分析282例住院治疗的感染性眼内炎患者的临床和实验室检测资料。患者中，男性206例，占73.05%；女性76例，占26.95%。年龄最小2岁，最大79岁，平均年龄（36.0±11.2）岁。除14例病情较重，无法保存眼球者以外，其余268例患者进行了玻璃体标本的病原学检测。临床和实验室检查数据采用Chi-square检验和Kappa一致性检验方法进行统计学分析，以P＜0.05为差异有统计学意义。结果 282例感染性眼内炎患者中，眼外伤所致者177例，占62.77%；感染性角膜炎所致者61例，占21.63%；眼部手术后所致者32例，占11.35%；内源性眼内炎12例，占4.25%。不同病因所致的感染性眼内炎患者中，2～13岁者占眼外伤所致者的19.21%；14～50岁者占感染性角膜炎所致者的55.74%；51～79岁者占眼部手术后所致者的60.61%。病原体检测显示，真菌和葡萄球菌属各占30.63%，为本组感染性眼内炎患者的主要病原体。其中，致病细菌对环丙沙星敏感者最多，占81.81％；庆大霉素次之，占77.92％。结论 感染性眼内炎的主要致病因素是眼外伤，真菌和葡萄球菌属是导致眼内感染的主要病原体。明确感染性眼内炎的不同致病因素、病原学特征有助于提供恰当的临床治疗。

Clinical analysis of 282 patients with infectious endophthalmitis

Objective To analyze the causes and pathogens of infectious endophthalmitis in ourhospital.Methods The clinical data and laboratory findings of 282 inpatients with infectiousendophthalmitis were retrospectively reviewed.There were 206 males(73.05%)and 76 females(26.95%)with a mean age of(36.0±11.2)years(range from 2 to 79 years).Except 14 patients who lost theireyeballs as of serious conditions.pathogen examinations of vitreous specimen had been performed for allremaining 268 cases.The clinieal and laboratory data were statistically analyzed by Chi-square and Kappaconsistency tests,when P<0.05 the difference should be considered as statistically significant.ResultsThe 4 major causes of infectious endophthalmitis of those 282 patients included ocular trauma(177cases,62.77%),infectious keratitis(61 cases,21.63%),eye surgery(32 cases,11.35%),andendogenous endophthalmitis(12 cases,4.25%).19.21% of the patients in ocular trauma group was 2-13years old,55.74% of the patients in infectious keratitis group was 14-50 years old,and 60.61% of thepatients in eye surgery group was 51-79 years old.The major pathogens were fungus and staphylococcieach accounted for 30.63% of all cases.Most of the pathogenic bacteria were sensitive to ciprofloxaein(81.81%)and gentamicin(77.92%).Conclusions The major reason of infectious endophthalmitis wasocular trauma,and the major pathogens were fungus and staphylococci.Those findings may help us totreat infectious endophthalmitis patients appropriately.