【摘要】：目的分析病原學(xué)診斷為細(xì)菌性角膜炎患者的臨床特征、病原菌分布、藥物敏感性及疾病轉(zhuǎn)歸。設(shè)計(jì)回顧性病例系列。研究對象2010年1月至2015年4月北京同仁醫(yī)院細(xì)菌培養(yǎng)陽性的角膜炎患者146例。方法對患者的臨床病歷資料統(tǒng)計(jì)分析臨床特征、病原菌分布以及藥物敏感試驗(yàn)結(jié)果等。主要指標(biāo)患者一般情況、臨床特征、治療及轉(zhuǎn)歸,以及細(xì)菌培養(yǎng)和藥敏試驗(yàn)結(jié)果。結(jié)果 146例均為單眼患病。平均年齡(46.7±18.97)歲,女性64例(43.84%)。眼外傷病史46例(31.5%)。76例(52.1%)就診前使用過局部抗菌素類藥物,19例(13.0%)使用過局部糖皮質(zhì)激素類藥物,15例(10.3%)聯(lián)合使用了抗生素和糖皮質(zhì)激素類藥物;病原菌82例(56.2%)為革蘭陽性菌、64例(43.8%)為革蘭陰性菌。假單胞菌(34.9%)最常見,其次為葡萄球菌(24.0%)。病原菌對加替沙星、阿米卡星和左氧氟沙星類藥物具有較高敏感性。139眼(95.2%)局部用藥治療病情好轉(zhuǎn)或治愈;7眼(4.8%)行手術(shù)治療。結(jié)論眼外傷是細(xì)菌性角膜炎最常見的危險(xiǎn)因素;革蘭陽性菌為較常見的病原菌類型,病原菌對加替沙星、阿米卡星和左氧氟沙星具較高敏感性,藥物控制不良時(shí)需積極采取手術(shù)治療。
[Abstract]:Objective to analyze the clinical characteristics, pathogen distribution, drug sensitivity and disease outcome of patients with bacterial keratitis diagnosed by etiology. A retrospective series of cases was designed. From January 2010 to April 2015, 146 patients with keratitis with positive bacterial culture in Beijing Tongren Hospital were enrolled in the study. Methods the clinical characteristics, pathogen distribution and drug sensitivity test results were statistically analyzed. Main outcome measures: general condition, clinical characteristics, treatment and prognosis, bacterial culture and drug sensitivity test results. Results 146 cases were monocular diseases. The average age was (46.7 鹵18.97) years, 64 cases (43.84%) were female. 46 cases (31.5%) had history of ocular trauma. 76 cases (52.1%) had been treated with local antibiotics and 19 cases (13.0%) had been treated with local glucocorticoids. 15 cases (10.3%) were treated with antibiotics and glucocorticoids. 82 cases (56.2%) were Gram-positive bacteria and 64 cases (43.8%) were Gram-negative bacteria. Pseudomonas (34.9%) was the most common, followed by Staphylococcus (24.0%). The pathogen was highly sensitive to gatifloxacin, amikacin and levofloxacin. 139 eyes (95.2%) were treated with local drugs for improvement or cure, and 7 eyes (4.8%) were treated surgically. Conclusion Eye trauma is the most common risk factor for bacterial keratitis. Gram-positive bacteria are common pathogenic bacteria. Gram-positive bacteria are highly sensitive to gatifloxacin, amikacin and levofloxacin. Surgical treatment should be taken actively when drug control is poor.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京朝陽醫(yī)院眼科;首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心北京市眼科研究所眼科學(xué)與視覺科學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;
【分類號】：R772.21

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王梅英;;光學(xué)相干斷層掃描在細(xì)菌性角膜炎體內(nèi)量化分析中的應(yīng)用[J];眼科新進(jìn)展;2010年11期

2 吳建華;中西醫(yī)結(jié)合治療細(xì)菌性角膜炎38例[J];安徽中醫(yī)學(xué)院學(xué)報(bào);1997年04期

3 Stephen J.Fr銉hlich;Herminia Mi濼odeKaspar;Thomas Grasbon;Caroline M銉hring;Volker Klauβ;Anselm Kampik;楊紅;;細(xì)菌性角膜炎微生物學(xué)分析作為指導(dǎo)治療的依據(jù)[J];德國醫(yī)學(xué);2000年03期

4 范欽華,郭鳴華,倪燦榮,李曉娣,沈茜;細(xì)胞間粘附分子-1在細(xì)菌性角膜炎角膜組織表達(dá)的實(shí)驗(yàn)研究[J];解放軍醫(yī)學(xué)雜志;2001年08期

5 孫旭光,王智群,羅時(shí)運(yùn),金秀英,張文華;細(xì)菌性角膜炎病原學(xué)分析[J];中華眼科雜志;2002年05期

6 孫旭靜,高萍;妥布霉素治療細(xì)菌性角膜炎[J];山西醫(yī)藥雜志;2003年03期

7 孫旭光;細(xì)菌性角膜炎診治進(jìn)展[J];中國醫(yī)刊;2003年06期

8 Parmar P.;Salman A.;Kalavathy C.M. ;潘佳鴻;;0.3%加替沙星和0.3%環(huán)丙沙星治療細(xì)菌性角膜炎的療效觀察[J];世界核心醫(yī)學(xué)期刊文摘.眼科學(xué)分冊;2006年05期

9 羅耀紅;朱惠安;;中西醫(yī)結(jié)合治療細(xì)菌性角膜炎35例[J];實(shí)用中醫(yī)藥雜志;2007年02期

10 梁艷闖;王智群;李然;梁慶豐;羅時(shí)運(yùn);鄧世靖;安瑩;孫旭光;;細(xì)菌性角膜炎病原學(xué)及耐藥性分析[J];眼科研究;2007年04期

相關(guān)會議論文 前3條

1 裘文亞;姚玉峰;;細(xì)菌性角膜炎菌種分布及抗菌藥物敏感性檢測[A];2011年浙江省眼科學(xué)術(shù)會議論文集[C];2011年

2 姚玉峰;;左旋氧氟沙星滴眼液治療細(xì)菌性角膜炎的前贍性臨床觀察研究[A];中華醫(yī)學(xué)會第十二屆全國眼科學(xué)術(shù)大會論文匯編[C];2007年

3 顧韞;;不同細(xì)菌感染角膜的臨床特征[A];2008年浙江省眼科學(xué)術(shù)會議論文集[C];2008年

相關(guān)碩士學(xué)位論文 前1條

1 劉慧;溶菌酶滴眼液的研制及對兔細(xì)菌性角膜炎模型的作用研究[D];山東大學(xué);2009年

，

本文編號：2483124