内源性细菌性眼内炎13例诊治的的体会.docVIP

内源性细菌性眼内炎13例诊治的的体会 　　摘要：目的回顾性分析13例确诊为内源性眼内炎患者的诊断及治疗，探讨内源性眼内炎的及时诊断及系统治疗方案。方法对我院2006~2012年收治的13例13眼确诊为内源性眼内炎的患者进行回顾性分析，分析患病是否具有易感因素，对不同患者治疗方法及预后进行总结。结果84.6%的患者存在易感因素；玻璃体及血培养阳性率为76.9%，革兰氏阳性细菌感染8例，革兰氏阴性细菌感染2例；3例未查到治病菌；所有确诊患者均首先进行玻璃体腔内注射万古霉素及头孢他啶各2mg，同时全身及眼局部应用抗生素，眼局部点激素类眼药水。上述处理后如病情缓解继续保守治疗的3例；感染不能控制，10例在全身条件允许时进行了彻底的玻璃体切割术。通过系统治疗后，13例患者中有10例保持或者提高了视力；1例因患者系统疾病死亡；2例最终眼球萎缩。结论内源性眼内炎的及时诊断对患者预后极为重要；规范的系统治疗可以最大可能保持甚至提高视力。 　　关键词：内源性；眼内炎；治疗 　　Diagnosis and Treatment of 13 Cases of Endogenous Bacterial Endophthalmitis 　　WU Xian-wei 　　(Benxi Central Hospital of China Medical University,Benxi 117000,Liaoning,China) 　　Abstract：ObjectiveA retrospective analysis of 13 cases of diagnosis and treatment of endogenous endophthalmitis, explore the diagnosis and treatment of endogenous endophthalmitis systemly. MethodsThe 2006~2012 hospital treated 13 cases of 13 eyes diagnosed with endogenous endophthalmitis were retrospectively analyzed, analysis of prevalence is a predisposing factor for different patients, treatment methods and prognosis were summarized. Results84.6% patients predisposing factors; the positive rate of vitreous and blood was 76.9%, 8 cases of infection of gram positive bacteria, gram negative bacteria infection in 2 cases; 3 cases were not found for bacteria; all patients were first injection of vancomycin and ceftazidime in the vitreous cavity 2mg, and application of whole body and local eye of antibiotics, topical ocular point hormone eye drops. The above treatments such as remission to 3 cases of conservative treatment; infection cannot be controlled, 10 cases in the body conditions allow a thorough vitrectomy. Through the systemly treatment, 13 cases in 10 patients to maintain or increase the vision; 1 died of disease ；2 cases finally atrophy of eyeball. ConclusionThe timely diagnosis of endogenous endophthalmitis on the prognosis of the patients is very important; treatment system specification can maintain or even improve eyesight. 　　Key words：Endogenous；