切换至 "中华医学电子期刊资源库"

中华眼科医学杂志(电子版) ›› 2017, Vol. 07 ›› Issue (06) : 284 -288. doi: 10.3877/cma.j.issn.2095-2007.2017.06.009

所属专题: 文献

综述

外伤性眼内炎临床诊断与治疗的研究进展
李林芮1, 赵小琴1, 杨桢1, 杨小丽1,()   
  1. 1. 637000 南充,川北医学院附属医院眼科
  • 收稿日期:2017-10-25 出版日期:2017-12-28
  • 通信作者: 杨小丽
  • 基金资助:
    四川省教育厅项目(17ZA0171); 四川省教育厅项目(15SB0113)

Research Progress on clinical diagnosis and treatment of traumatic endophthalmitis

Linrui Li1, Xiaoqin Zhao1, Zhen Yang1, Xiaoli Yang1,()   

  1. 1. Depatartment of Ophthalmology, Affiliated Hospital of North Sichuan Medical college, Nanchong 637000, China
  • Received:2017-10-25 Published:2017-12-28
  • Corresponding author: Xiaoli Yang
  • About author:
    Corresponding author: Yang Xiaoli, Email:
引用本文:

李林芮, 赵小琴, 杨桢, 杨小丽. 外伤性眼内炎临床诊断与治疗的研究进展[J]. 中华眼科医学杂志(电子版), 2017, 07(06): 284-288.

Linrui Li, Xiaoqin Zhao, Zhen Yang, Xiaoli Yang. Research Progress on clinical diagnosis and treatment of traumatic endophthalmitis[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(06): 284-288.

外伤性眼内炎是眼外伤后较易发生的并发症,也是主要致盲性眼部疾病之一。炎症反应发展迅速,可快速波及眼球及周围软组织并发展为眼球周围炎。若延误处理,可能导致失明等严重后果。因此,及早发现外伤性眼内炎,确认病原体并及时准确的进行处理,对挽救患者视力具有重要意义。本文中笔者对目前国内外外伤性眼内炎的研究进展进行回顾,就其发病的危险因素、临床表现、诊断及治疗等问题进行综述。

Traumatic endophthalmitis is an easy complication after ocular trauma, and it is also one of the main blindness ocular diseases. The inflammatory reaction develops rapidly, and can rapidly spread the eyeball and surrounding soft tissues and develop peri peritis. If delayed treatment may result in serious consequences, such as blindness. Therefore, early detection of traumatic endophthalmitis, identification of pathogens and timely and accurate treatment, to save the visual acuity of the patient is of great significance. In this paper, I reviewed the research progress at home and abroad, and reviewed the risk factors, clinical manifestations, diagnosis and treatment of this disease.

[1]
Peyman GA,Carroll CP,Raichand M. Prevention and management of traumatic endophthalmitis[J]. Ophthalmology, 1980, 87(4): 320-324.
[2]
罗兴中,杨爱维. 眼球穿孔伤发生眼内炎的危险因素探讨[J]. 中华眼外伤职业眼病杂志, 2001, 9(5): 488-489.
[3]
Jonas JB,Knorr HL,Budde WM. Prognostic factors in ocular injuries caused by intraocular or retrobulbar foreign bodies[J]. Ophthalmology, 2000, 107(5): 823-828.
[4]
Agrawal R. Post-traumatic endophthalmitis[J]. Eye, 2012, 26(9): 1277-1278.
[5]
张效房,朱豫. 我国眼外伤研究50年成就[J]. 中华眼科杂志, 2000, 36(3): 212-216.
[6]
张效房,朱豫. 二十一世纪眼外伤面临的挑战[J]. 中华眼外伤职业眼病杂志, 2000, 22(1): 3-5.
[7]
Andreoli CM,Andreoli MT,Kloek CE, et al. Low rate of endophthalmitis in a large series of open globe injuries[J]. Am J Ophthalmol, 2009, 147(4): 601-608.
[8]
王化峰,于强,刘永民, 等. 眼内异物169例眼内炎发病因素分析[J]. 中国实用眼科杂志, 2012, 30(4): 489-491.
[9]
王化峰,于强,刘永民, 等. 外伤性眼内炎发病危险因素分析[J]. 中国实用眼科杂志, 2011, 29(7): 689-691.
[10]
龚莉莉,秦岭. 玻璃体切除联合玻璃体腔注药治疗外伤所致眼内炎[J]. 国际眼科杂志, 2009, 9(1): 190-191.
[11]
尚彦霞. 外伤性眼内炎的病原学诊断及相关因素分析[J]. 中国实验诊断学, 2013, 17(2): 298-299.
[12]
王洪格,董晓光,田景毅. 外伤性眼内炎的临床治疗分析[J]. 中国实用眼科杂志, 2008, 26(8): 795-797.
[13]
南安超,李秋明. 外伤性眼内炎122例临床分析研究[J]. 中华眼外伤职业眼病杂志, 2011, 33(3): 206-208.
[14]
游昌涛,岳立晖. 玻璃体切除术治疗外伤后眼内炎[J]. 中华眼外伤职业眼病杂志, 2012, 34(9): 651-654.
[15]
叶存喜,马景学,张斌, 等. 眼内炎的分级标准和临床意义[J]. 中国实用眼科杂志, 2005, 23(4): 401-402.
[16]
金勤,郑伟军,刘欣, 等. 外伤性眼内炎的临床治疗与围手术期护理[J]. 中华医院感染学杂志, 2013, 23(17): 4185-4187.
[17]
庞秀琴,王文伟. 同仁眼外伤手术治疗学[M]. 北京: 北京科学技术出版社, 2006: 187-189.
[18]
卢嘉彪,林振德,邹玉平. 304例化脓性眼内炎细菌培养结果分析[J]. 中华眼科杂志, 2000, 36(5): 355-357.
[19]
Yang CS,Lu CK,Lee FL, et al. Treatment and outcome of traumatic endophthalmitis in open globe injury with retained intraocular foreign body[J]. Ophthalmologica, 2009, 224(2): 79-85.
[20]
Ramakrishnan R,Bharathi MJ,Shivkumar C, et al. Microbiological profile of culture-proven cases of exogenous and endogenous endophthalmitis: a 10-year retrospective study[J]. Eye, 2008, 23(4): 945-956.
[21]
Gupta A,Srinivasan R,Gulnar D, et al. Risk factors for post-traumatic endophthalmitis in patients with positive intraocular cultures[J]. European Journal of Ophthalmology, 2007, 17(4): 642-647.
[22]
杨瑶,袁钊辉,汪振芳, 等. 447例感染性眼内炎病原体及药物敏感性分析[J]. 中华实验眼科杂志, 2013, 31(5): 456-460.
[23]
Benz MS,Scott IU,HWF Jr, et al. Endophthalmitis isolates and antibiotic sensitivities: a 6-year review of culture-proven cases[J]. Am J Ophthalmol, 2004, 137(1): 38-42.
[24]
Chhabra S,Kunimoto DY,Kazi L, et al. Endophthalmitis After Open Globe Injury: Microbiologic Spectrum and Susceptibilities of Isolates[J]. Am J Ophthalmol, 2006, 142(5): 852-854.
[25]
Eser I,Kapran Z,Altan T, et al. Isolates and antibiotic sensitivity of eighty culture-proven endophthalmitis cases from Istanbul[J]. Ophthalmologica, 2008, 222(3): 157-160.
[26]
徐一,毛丽萍,王大选, 等. 浙南地区外伤感染性眼内炎病因及病原体分析[J]. 中华眼外伤职业眼病杂志, 2016, 38(10): 787-790.
[27]
Sakamoto H,Sakamoto M,Hata Y, et al. Aqueous and vitreous penetration of levofloxacin after topical and/or oral administration[J]. Eur J Ophthalmol, 2007, 17(3): 372-376.
[28]
Granneman GR,Sennello LT. High-performance liquid chromatographic procedures for the determination of difloxacin and its metabolites in biological matrices[J]. Journal of Chromatography, 1991, 568(1): 197-206.
[29]
Bhavsar AR,Googe JMJ,Stockdale CR, et al. Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required: the Diabetic Retinopathy Clinical Research Network laser-ranibizumab-triamcinolone clinical trials[J]. Arch Ophthalmology, 2009, 127(12): 1581-1582.
[30]
Hospenthal DR,Murray CK,Andersen RC, et al. Guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society[J]. Journal of Trauma, 2011, 71(Suppl. 2): 202-209.
[31]
郑霄,赵刚平,李山祥, 等. 早期玻璃体切除术治疗重症外伤性眼内炎的疗效[J]. 国际眼科杂志, 2013, 13(8): 1691-1693.
[32]
Bali E,Huyghe P,Caspers L, et al. Vitrectomy and silicone oil in the treatment of acute endophthalmitis. Preliminary results[J]. Bull Soc Belge Ophtalmol, 2003, 288(1): 9-14.
[33]
黎晓新,张正. 眼内炎的诊断与处理及预防[J]. 中华眼科杂志, 2006, 42(10): 946-950.
[34]
Listed N. Results of the Endophthalmitis Vitrectomy Study. A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis[J]. Arch Ophthalmol, 1995, 113(12): 1479-1496.
[35]
Endophthalmitis Study Group. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors[J]. J Cataract Refract Surg, 2007, 33(6): 978-988.
[36]
Dhoot SB,Kunjukunju N,Sabates N. The Role of Prophylactic Antibiotic Use in Prevention of Endophthalmitis Following Intravitreal Injection of Anti-Vascular Endothelial Growth Factor Agents: A Meta-Analysis[J]. Open Journal of Ophthalmology, 2013, 3(2): 46-49.
[37]
Kim HW,Kim SY,Chung IY, et al. Emergence of Enterococcus, species in the infectious microorganisms cultured from patients with endophthalmitis in South Korea[J]. Infection, 2013, 42(1): 113-118.
[38]
Christy NE,Lall P. A randomized, controlled comparison of anterior and posterior periocular injection of antibiotic in the prevention of postoperative endophthalmitis[J]. Ophthalmic Surgery, 1986, 17(11): 715-718.
[39]
任慧,江睿,徐格致, 等. 眼内镜下玻璃体切除术治疗伴角膜混浊的严重眼外伤的疗效观察[J]. 中华眼科杂志, 2014, 50(3): 194-196.
[40]
宋秋颖,王冬兰. 显微眼内窥镜引导玻璃体视网膜手术治疗伴有角膜混浊的复杂性眼外伤临床疗效观察[J]. 齐齐哈尔医学院学报, 2015, 36(11): 1608-1609.
[41]
毛静海,周和定. 内窥镜引导玻璃体手术治疗伴屈光介质混浊眼内炎的疗效观察[J]. 现代实用医学, 2014, 26(3): 344-345.
[42]
Mordenti J,Cuthbertson RA,Ferrara N, et al. Comparisons of the intraocular tissue distribution, pharmacokinetics, and safety of 125I-labeled full-length and Fab antibodies in rhesus monkeys following intravitreal administration[J]. Toxicologic Pathology, 1999, 27(5): 536-544.
[43]
Yanyali A,Cetin S,Talu H, et al. Effect of Sulfur Hexafluoride Gas on Antibacterial Activity of Antibiotics in vitro against Agents Causing Endophthalmitis[J]. Ophthalmologica, 2001, 215(6): 439-443.
[44]
Bhagat N,Nagori S,Zarbin M. Post-traumatic Infectious Endophthalmitis[J]. Survey of Ophthalmology, 2011, 56(3): 214-251.
[45]
毛子清,游志鹏,周五剑, 等. 眼内窥镜引导下玻璃体手术治疗外伤性眼内炎的效果[J]. 广东医学, 2016, 37(20): 3095-3098.
[46]
Callegan MC,Gilmore MS,Gregory M, et al. Bacterial endophthalmitis: Therapeutic challenges and host-pathogen interactions[J]. Progress in Retinal & Eye Research, 2007, 26(2): 189-203.
[47]
Dotrelová D,Dvorák J,Kalvodová B, et al. Pars plana vitrectomy and primary implantation of silicone oil in the treatment of acute exogenous endophthalmitis in eyes without retinal detachment[J]. Cesk Slov Oftalmol, 2003, 59(3): 146-152.
[48]
Johnson RN,Jr FH,Parel JM, et al. Transient hypopyon with marked anterior chamber fibrin following pars plana vitrectomy and silicone oil injection[J]. Arch Ophthalmol, 1989, 107(5): 683-686.
[49]
白领娣,刘芳,刘鹏飞, 等. 外伤性眼内炎玻璃体手术的预后因素分析[J]. 国际眼科杂志, 2009, 9(9): 1781-1782.
[50]
Rd AD,Hudson SJ,Kasowski EJ, et al. Experimental pseudomonal posttraumatic endophthalmitis in a swine model. Treatment with ceftazidime, amikacin, and imipenem[J]. Retina, 1997, 17(2): 139-145.
[51]
Ay GM,Akhan SC,Erturk S, et al. Comparison of Intravitreal Ceftazidime and Meropenem in Treatment of Experimental Pseudomonal Posttraumatic Endophthalmitis in a Rabbit Model[J]. Journal of Applied Research, 2004, 4(2): 336-345.
[52]
Ozkiri A,Evereklioglu C,Akgün H, et al. A comparison of intravitreal piperacillin/tazobactam with ceftazidime in experimental Pseudomonas aeruginosa endophthalmitis[J]. Experimental Eye Research, 2005, 80(3): 361-367.
[53]
ÃZkiris A,Evereklioglu C,Esel D, et al. The Efficacy of Piperacillin/Tazobactam in Experimental Pseudomonas aeruginosa Endophthalmitis: A Histopathological and Microbiological Evaluation[J]. Current Eye Research, 2005, 30(1): 13-19.
[54]
Özkiriş A,Evereklioglu C,Eşel D, et al. The Efficacy of Intravitreal Piperacillin/Tazobactam in Rabbits with Experimental Staphylococcus epidermidis Endophthalmitis: A Comparison with Vancomycin[J]. Ophthalmic Research, 2005, 37(3): 168-174.
[55]
Ng EW,D'Amico DT. Therapeutic efficacy of intravitreal ceftazidime, imipenem, and amikacin in a swine model of posttraumatic Pseudomonas aeruginosa endophthalmitis[J]. Retina, 1997, 17(5): 464-465.
[56]
Alfaro DV,Davis J,Kim S, et al. Experimental Bacillus cereus post-traumatic endophthalmitis and treatment with ciprofloxacin[J]. Br J Ophthalmol, 1996, 80(8): 755-758.
[57]
周和定,毛静海. 20G与23G玻璃体切割手术治疗感染性眼内炎临床效果分析[J]. 中华眼底病杂志, 2012, 28(3): 249-253.
[58]
黎晓新,王景昭. 玻璃体视网膜手术学[M]. 北京: 人民卫生出版社, 2000: 368-369.
[59]
Davey PG,Barza M,Stuart M. Dose response of experimental Pseudomonas endophthalmitis to ciprofloxacin, gentamicin, and imipenem: evidence for resistance to "late" treatment of infections[J]. Journal of Infectious Diseases, 1987, 155(3): 518-523.
[60]
Fungtomc J,Kolek B,Bonner DP. Ciprofloxacin-induced, low-level resistance to structurally unrelated antibiotics in Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus[J]. Antimicrobial Agents and Chemotherapy, 1993, 37(6): 1289-1296.
[61]
Karlowsky JA,Draghi DC,Jones ME, et al. Surveillance for Antimicrobial Susceptibility among Clinical Isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from Hospitalized Patients in the United States, 1998 to 2001[J]. Antimicrobial Agents and Chemotherapy, 2003, 47(5): 1681-1688.
[62]
Chaudhry IA,Shamsi FA,AlHarthi E, et al. Incidence and visual outcome of endophthalmitis associated with intraocular foreign bodies[J]. Graefe's Archive for Clinical and Experimental Ophthalmology, 2008, 246(2): 181-186.
[63]
Das T,Kunimoto DY,Sharma S, et al. Relationship between clinical presentation and visual outcome in postoperative and posttraumatic endophthalmitis in south central India[J]. Indian Journal of Ophthalmology, 2005, 53(1): 5-16.
[64]
Gokce G,Sobaci G,Ozgonul C. Post-Traumatic Endophthalmitis: A Mini-Review[J]. Semin Ophthalmol. 2014, 30(5): 1-5.
[65]
Faghihi H,Hajizadeh F,Esfahani MR, et al. Posttraumatic endophthalmitis: report No. 2[J]. Retina, 2012, 32(1): 146-151.
[66]
Essex RW,Allen PJ. Posttraumatic Endophthalmitis: Author reply[J]. Ophthalmology, 2005, 112(10): 1846-1847.
[67]
Asencio MA,Huertas M,Carranza R, et al. Microbiological study of infectious endophthalmitis with positive culture within a 13 year-period[J]. Revista Espanola De Quimioterapia, 2014, 27(1): 22-27.
[68]
王化峰,苏丹,刘永民,等. 外伤后眼内炎发病危险因素[C].郑州:中华医学会全国眼科学术大会. 2007.
[69]
Thompson WS,Rubsamen PE,Jr FH, et al. Endophthalmitis after penetrating trauma. Risk factors and visual acuity outcomes[J]. Ophthalmology, 1995, 102(11): 1696-1701.
[70]
Soheilian M,Rafati N,Mohebbi MR, et al. Prophylaxis of acute posttraumatic bacterial endophthalmitis: a multicenter, randomized clinical trial of intraocular antibiotic injection, report 2[J]. Archives Ophthalmology, 2007, 125(4): 460-465.
[71]
Zhang Y,Zhang MN,Jiang CH, et al. Endophthalmitis following open globe injury[J]. Bri J Ophthalmol, 2010, 94(1): 111-114.
[1] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 809-815.
[2] 马艳波, 华扬, 刘桂梅, 孟秀峰, 崔立平. 中青年人颈动脉粥样硬化病变的相关危险因素分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 822-826.
[3] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[4] 吴方园, 孙霞, 林昌锋, 张震生. HBV相关肝硬化合并急性上消化道出血的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 45-47.
[5] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[6] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[7] 莫闲, 杨闯. 肝硬化患者并发门静脉血栓危险因素的Meta分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 678-683.
[8] 毛永欢, 仝瀚文, 缪骥, 王行舟, 沈晓菲, 喻春钊. 造口旁疝危险因素预测模型构建[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 682-687.
[9] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[10] 侯超, 潘美辰, 吴文明, 黄兴广, 李翔, 程凌雪, 朱玉轩, 李文波. 早期食管癌及上皮内瘤变内镜黏膜下剥离术后食管狭窄的危险因素[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 383-387.
[11] 张雯, 宋牡丹, 邓雪婷, 张云. 强化营养支持辅助奥曲肽治疗肝硬化合并食管胃底静脉曲张破裂出血的疗效及再出血危险因素[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 456-460.
[12] 陆猛桂, 黄斌, 李秋林, 何媛梅. 蜂蛰伤患者发生多器官功能障碍综合征的危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1010-1015.
[13] 李达, 张大涯, 陈润祥, 张晓冬, 黄士美, 陈晨, 曾凡, 陈世锔, 白飞虎. 海南省东方市幽门螺杆菌感染现状的调查与相关危险因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 858-864.
[14] 李琪, 黄钟莹, 袁平, 关振鹏. 基于某三级医院的ICU多重耐药菌医院感染影响因素的分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 777-782.
[15] 孟科, 李燕, 闫婧爽, 闫斌. 胶囊内镜胃通过时间的影响因素分析[J]. 中华临床医师杂志(电子版), 2023, 17(06): 671-675.
阅读次数
全文


摘要