年龄相关性白内障患者超声乳化术后并发眼内感染的风险因素分析
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Risk factors for endophthalmitis in age-related cataract patients undergoing phacoemulsification
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    摘要:

    目的:探讨影响年龄相关性白内障患者超声乳化手术治疗后的眼内感染风险因素,为降低术后眼内感染发生率提供合理干预对策,提高治疗效果。

    方法:选取我院2012-06/2017-03收治的4 500例6 180眼进行超声乳化手术治疗的年龄相关性白内障患者病历资料进行分析,对于出现手术后眼内感染的患者进行玻璃体穿刺,收集标本进行采集培养和检查,分析感染性病原菌分布情况、患者年龄、术前慢性病史、手术切口等各种因素对发生眼内感染的影响,数据采用SPSS 18.0统计软件进行分析处理。

    结果:本研究中,所有患者超声乳化术后眼内感染发生率为0.19%(12/6180),年龄≥75岁、伴有糖尿病、采取透明角膜切口手术的患者,术后眼内感染发生率明显更高,差异具有统计学意义(P<0.05); 手术过程中玻璃体溢出和晶状体后囊破裂的术后眼内感染发生率分别为60.00%(9/15)和66.67%(8/12),明显高于未发生患者,差异有统计学意义(P<0.01)。

    结论:对于年龄≥75岁、伴有糖尿病的白内障患者术前应提前做好干预措施,手术过程中应合理选择手术切口并尽量避免玻璃体溢出和晶状体后囊破裂等并发症,以降低眼内感染发生率,提高患者术后恢复和手术成功率。

    Abstract:

    AIM: To explore the risk factors for endophthalmitis in age-related cataract patients undergoing phacoemulsification, in order to provide reasonable intervention countermeasures to reduce the incidence of eddophthalmitis after phacoemulsification, increase the surgery efficacy.

    METHODS: The 4 500 cases(6 180 eyes)of age-related cataract patients with phacoemulsification in our hospital were analyzed, and cases of endopathalmitis needed to have vitreous puncture to collect the sample for analysis, the infectious bacteria, funfal distribution and the operation time, patients age, complications, surgical incision were analyzed for the risk factors of endophthalmitis in senile cataract patients. Data were statistically analyzed by SPSS 18.0.

    RESULTS: In our study, among the 4500 cases(6180 eyes)with phacoemulsification, the endophthalmitis infection rate was 0.19%(12/6180), the incidence of endophthalmitis was significantly higher in patients with age ≥75 years, with diabetes, hypertension, coronary heart disease history, and the temporal transparent corneal tunnel incision surgery(P<0.05). The vitreous overflow and the posterior capsule broken in the operative process of the endophthalmitis infection were 60.00%(9/15)and 66.67%(8/12), more higher than patients with no symptoms obviously(P<0.01).

    CONCLUSION: For the cataract patients over 75 years old or with diabetes, interventions should be done well before surgery. Surgical incision should be selected in the surgical procedure and avoid complications such as vitreous overflow and posterior capsular rupture in order to reduce the incidence of intraocular infection and improve the postoperative recovery.

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葛磊,葛程.年龄相关性白内障患者超声乳化术后并发眼内感染的风险因素分析.国际眼科杂志, 2018,18(2):336-339.

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  • 收稿日期:2017-06-26
  • 最后修改日期:2017-12-25
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  • 在线发布日期: 2018-01-19
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