CAJ | 학술논문

目的观察玻璃体切割联合晶状体切除、硅油填充术治疗重度外源性眼内炎的效果.方法对2009年6月至2012年12月在聊城市医院眼科就诊的28例(28只眼)重度外源性眼内炎患者的临床资料进行回顾性分析.所有患者均进行最佳矫正视力、眼压、裂隙灯显微镜、直接和间接检眼镜检查及眼B型超声检查后确诊.28只眼进行玻璃体切割联合晶状体切除、硅油填充手术治疗.所有患者治疗前均常规抽取玻璃体积脓送细菌培养加药物敏感试验及真菌培养加药物敏感试验.手术后随访12～36个月,观察分析手术前后眼球保留情况、视力和眼压改善情况.结果 28只眼中,手术后炎症控制,保留眼球者27只眼,占96.43％ (27/28).27只患眼中,24只眼视力提高,占88.89％ (24/27);2只眼视力不变,占7.41％ (2/27);1只眼视力下降,占3.70％ (1/27),术后1、12个月视力与术前视力相比较,差异有统计学意义(x2=34.11,P＜0.01).术后眼压较手术前降低,差异有统计学意义(x2=7.42,P＜0.05).28分玻璃体标本中,培养结果阳性者11例,检出率为39.29％ (11/28).结论玻璃体切割联合晶状体切除、硅油填充术是治疗重度外源性眼内炎的有效方法,术后并发症主要是增生性玻璃体视网膜病变和视网膜脱离.
목적 관찰파리체절할연합정상체절제、규유전충술치료중도외원성안내염적효과.방법 대2009년6월지2012년12월재료성시의원안과취진적28례(28지안)중도외원성안내염환자적림상자료진행회고성분석.소유환자균진행최가교정시력、안압、렬극등현미경、직접화간접검안경검사급안B형초성검사후학진.28지안진행파리체절할연합정상체절제、규유전충수술치료.소유환자치료전균상규추취파리체적농송세균배양가약물민감시험급진균배양가약물민감시험.수술후수방12～36개월,관찰분석수술전후안구보류정황、시력화안압개선정황.결과 28지안중,수술후염증공제,보류안구자27지안,점96.43％ (27/28).27지환안중,24지안시력제고,점88.89％ (24/27);2지안시력불변,점7.41％ (2/27);1지안시력하강,점3.70％ (1/27),술후1、12개월시력여술전시력상비교,차이유통계학의의(x2=34.11,P＜0.01).술후안압교수술전강저,차이유통계학의의(x2=7.42,P＜0.05).28분파리체표본중,배양결과양성자11례,검출솔위39.29％ (11/28).결론 파리체절할연합정상체절제、규유전충술시치료중도외원성안내염적유효방법,술후병발증주요시증생성파리체시망막병변화시망막탈리.
Objective To observe the effect of vitrectomy combined with lensectomy,silicone oil tamponade for severe exogenous endophthalmitis.Methods The clinical data of 28 patients (28 eyes) with severe exogenous endophthalmitis were analyzed retrospectively.All patients diagnosed by best corrected visual acuity,intraocular pressure,slit-lamp microscopy,direct and indirect ophthalmoscope examination and intraocular B-ultrasound examination.Surgery (vitrectomy,lensectomy,silicone oil tamponade) was performed in all 28 patients.Vitreous purulence was taken in all patients before vitrectomy for bacterial,fungal culture and drug sensitivity test.The follow-up was 12 to 36 months.The preoperative and postoperative visual acuity,intraocular pressure and eye retention situation were observed.Results Endophthalmitis was controlled in 27/28 eyes (96.43％) after surgery.The visual acuity improved significantly at 1 month and 12 months after surgery (P ＜0.01).Conclusions Vitrectomy combined with lensectomy,silicone oil tamponade is effective for severe exogenous endophthalmitis.The major postoperative complications are proliferative vitreoretinopathy and retina detachment.