目的 分析内源性眼内炎的临床特点、全身易发因素及诊疗过程、治疗结果。方法 回顾性分析11例 (14眼) 内源性眼内炎患者全身及眼部情况、就诊过程、治疗方法及视力预后。结果 11例中,9例伴有全身系统性疾病,54.5%患者眼部疾病前有发热史,63.6%病例有外科手术史,眼部发病至就诊时间为7~60 d,平均27.3 d。进行血或玻璃体液涂片、培养,阳性5例 (45.5%),其中真菌 3例(27.3%),细菌和真菌混合感染2例(18.2%)。81.8%存在全身易感因素,最常见为外科手术后。13只眼行玻璃体切除手术,12眼(85.7%)获得眼前手动以上视力,其中6眼 (42.9%)术后视力达 0.1以上。结论 转移性眼内炎的大部分患者存在全身易感因素或有大外科手术史,半数以上患者有发热史,追问三项联合病史对诊断有帮助。警惕此病尽早诊断是预后的关键,目前的治愈率提高不明显。
Abstract
Objective To analyze the clinical characteristics, systemic risk factors, diagnosis and treatment outcomes of endogenous endophthalmitis. Methods The clinical data of a total of 11 patients (14 eyes) with endogenous endophthalmitis was reviewed retrospectively. Results Of the 11 patients, 81.8% had systemic systemic diseases, 54.5% had a history of fever before ocular diseases, 63.6% had undergone surgery, and the time interval between the onset of the disease and treatment was 7～60 days, with an average of 27.3 days. Smear and culture of blood or the vitreous humor were positive in 5 cases (45.5%), including 3 (27.3%) cases of fungi infection and 2 (18.2%) cases of mixed infection of bacteria and fungi. 81.8% of these patients were vulnerable to systemic risk factors, most frequently after major surgery. Vitrectomy was performed in 13 eyes and visual acuity in 12 eyes (85.7%). Six eyes (42.9%) resumed visual acuity above 0.1. Conclusions Most of the patients with metastatic endophthalmitis are vulnerable or have received major operations. More than half of the patients have a history of fever. The combination of the three factors can help diagnosis. Fungi are common pathogens. Quick diagnosis is the key to prognosis. The curative rate has not been improved significantly so far.
关键词
内源性眼内炎 /
全身易感因素 /
玻璃体切除术
Key words
endogenous endophthalmitis /
systemic predisposing factors /
vitrectomy
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