儿童感染性眼内炎的病因学分析

目的 对儿童感染性眼内炎的病因学和病原学进行探讨,指导临床诊断和治疗.方法 对2001年1月～2005年12月间山东省眼科研究所青岛眼科医院收治的42例儿童感染性眼内炎患者的病史、病因学、病原学检查和治疗策略等进行回顾性分析.结果 儿童感染性眼内炎由眼外伤导致者最多,占38例(90.5%).病原体培养阳性标本24例(57.1%),其中革兰阳性球菌(45.8%)尤其是葡萄球菌属(41.7%)是主要的病原体,其次为革兰阴性菌中的假单胞菌属(20.8%);真菌感染占12.5%.致病细菌对庆大霉素和环丙沙星敏感者最多,分别为92.3%和84.6%.治疗上,73.8%的患者接受了玻璃体切割手术治疗,88.1%的患者出院时临床效果良好.结论 眼外伤是儿童感染性眼内炎最主要的致病因素,玻璃体标本涂片和培养有利于明确眼内炎的性质,多种敏感抗生素的玻璃体联合注药和玻璃体切割是有效的治疗方法.

Etiology of infectious endophthalmitis in pediatric age group

Objective To analyze the etiology and laboratory findings of infectious endophthalmitis in pediatric age group in order to improve clinical diagnosis and treatment.Methods The medical and microbial records of all inpatients 14 years and younger between January 2001 and December 2005 were retrospectively reviewed for history,etiology,microbial spectrum and treatment strategy.Results Post-trauma endophthalmitis was predominant in pediatric age group(38 cases,90.5%).Culture-positive isolates was 24 charts(57.1%):Gram-positive organisms,especially Staphylococci was most common(41.7%),followed by pseudomonas species(20.8%)and fungi(12.5%).Bacteria were most susceptible to gentamicin and ciprofloxacin,92.3% and 84.6% respectively.31 patients received vitrectomy(73.8%)and among which 88.1% got benificial therapy.Conclusion Tauma is predominant risk factor of infectious endophthalmitis in pediatric age group.Knowledge of the most frequent causative organisms will help direct appropriate therapy.ntravitreal injection of various sensitive antibiotics and vitrectomy are effective way for treatment of endophthalmitis in pediatric age group.