内源性眼内炎病因和临床治疗13例分析

目的分析内源性眼内炎的病因、全身易感因素及治疗结果。方法回顾13例（14眼）内源性眼内炎患者发病时的全身状况及眼部情况,玻璃体液的涂片和培养结果,治疗方法和视力愈后。结果13例（14眼）内源性眼内炎均行玻璃体液涂片和培养,阳性9例（10眼）,其中细菌6例（7眼）,包括革兰阳性球菌2例（2眼）、大肠埃希菌1例（1眼）、结核杆菌1例（1眼）、绿脓杆菌2例（3眼）;真菌3例（3眼）。11例患者有全身易感因素。在药物治疗的同时,除2眼行眼内容摘出外,其余均行玻璃体切割术,7眼保住眼球并有数指或以上视力,其中2眼最终视力〉0.05。结论内源性眼内炎的病因为全身感染性病灶或败血症的微生物感染所致,包括细菌和真菌感染,处理棘手,及时行玻璃体切割术,有助于改善患者的视力愈后。

Analysis of cause and clinical treatment in 13 cases with endogenous endophthalmitis

Objective To analyze the causative organism,predisposing factors and therapeutic results of endogenous endophthalmitis.Methods The condition of eye and body,the cultured results of vitreous body liquid,therapeutic methods and final visual acuity after treatment of 13 patients(14 eyes) with endogenous endophthalmitis were retrospectively analyzed.Results The vitreous body liquid in 13 cases(14 eyes) were all cultured,9 cases(10 eyes) had a positive smear or cultured outcome,and 6 cases(7 eyes) showed bacteria infection and 3 cases(3 eyes) fungi infection.Eleven eyes (76.92%) had predisposing factors.Nine eyes received vitrectomy,the eyeballs in 7 eyes was remained and the final visual acuity in 2 eyes were better than 0.05.Conclusion Endogenous endophthalmitis is caused by bacteria and fungi from systemic focus of infection and sepsis,and is difficult to treat.Vitrectomy in time can help to improve their visual acuity.