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三级综合医院成人眼眶蜂窝织炎的临床特征与预后

Clinical Characteristics and Prognosis of Adult Orbital Cellulitis in a Tertiary General Hospital.

作者信息

Yao Bangtao, Ding Yuhua, Zhao Xiaogui, Wang Bei, Liu Gang, Wang Fei

机构信息

Department of Ophthalmology, Lishui District People's Hospital, Nanjing, Jiangsu Province, China.

Department of Ophthalmology, Lishui Branch of Southeast University Affiliated Zhongda Hospital, Nanjing, Jiangsu Province, China.

出版信息

J Ophthalmol. 2020 Dec 8;2020:8889341. doi: 10.1155/2020/8889341. eCollection 2020.

Abstract

PURPOSE

Adult orbital cellulitis (OC) occurs relatively rarely, and comprehensive studies that retrospectively evaluate OC are lacking. Here, we aimed to examine the clinical characteristics and prognosis of OC in a tertiary general hospital.

METHODS

Between October 2010 and May 2019, patients presenting with clinical symptoms of OC in a tertiary general hospital were analyzed in this retrospective study. Twenty-six cases were identified for a detailed review. In these cases, 16 males and 10 females were diagnosed with orbital cellulitis by clinical characteristics and multimodal examinations. We divided patients into three groups: (1) patients secondary to rhinosinusitis, (2) patients secondary to endogenous infection(s) without endophthalmitis, and (3) patients secondary to endophthalmitis. For each group, age, gender, eye type, combined systemic diseases, clinical presentation, leukocyte count, blood culture, diagnostic imaging, therapeutic methods, length of stay, time of postoperation, and patient prognosis were analyzed in detail.

RESULTS

There were no significant differences regarding age, gender, preoperative leukocyte count, exophthalmia, blood culture, treatment, or visual changes within the three groups ( < 0.05). There were significant differences, however, in postoperative leukocyte count and ophthalmoplegia between the three groups ( < 0.05). The preoperative and postoperative logarithms of the minimum resolution angle scored by the best-corrected visual acuity (LogMAR BCVA) of group 3 were statistically significant compared to group 1 and group 2 ( < 0.05).

CONCLUSION

We confirmed that the prognosis of OC patients combined with systemic diseases was poor. Patients with OC secondary to endophthalmitis infrequently experience ophthalmoplegia; however, these patients still have poor visual outcomes. Patients cultured positive for infection may not be associated with liver abscess. The level of leukocytes may indicate the condition of the disease.

摘要

目的

成人眼眶蜂窝织炎(OC)相对少见,缺乏对OC进行回顾性评估的全面研究。在此,我们旨在研究一家三级综合医院中OC的临床特征和预后。

方法

在这项回顾性研究中,分析了2010年10月至2019年5月期间在一家三级综合医院出现OC临床症状的患者。确定了26例进行详细审查。在这些病例中,16例男性和10例女性通过临床特征和多模式检查被诊断为眼眶蜂窝织炎。我们将患者分为三组:(1)鼻窦炎继发患者,(2)无眼内炎的内源性感染继发患者,(3)眼内炎继发患者。对每组患者的年龄、性别、眼别、合并的全身性疾病、临床表现、白细胞计数、血培养、诊断性影像学检查、治疗方法、住院时间、术后时间和患者预后进行了详细分析。

结果

三组在年龄、性别、术前白细胞计数、眼球突出、血培养、治疗或视力变化方面无显著差异(<0.05)。然而,三组在术后白细胞计数和眼球运动障碍方面存在显著差异(<0.05)。与第1组和第2组相比,第3组最佳矫正视力(LogMAR BCVA)评分的最小分辨角术前和术后对数具有统计学意义(<0.05)。

结论

我们证实合并全身性疾病的OC患者预后较差。眼内炎继发的OC患者很少出现眼球运动障碍;然而,这些患者的视力预后仍然较差。感染培养阳性的患者可能与肝脓肿无关。白细胞水平可能表明疾病状况。

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Indicators for imaging in periorbital cellulitis secondary to rhinosinusitis.鼻窦炎继发眶周蜂窝织炎的影像学检查指标。
Eur Arch Otorhinolaryngol. 2018 Apr;275(4):943-948. doi: 10.1007/s00405-018-4897-4. Epub 2018 Feb 15.
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Orbital cellulitis.眶蜂窝织炎。
Surv Ophthalmol. 2018 Jul-Aug;63(4):534-553. doi: 10.1016/j.survophthal.2017.12.001. Epub 2017 Dec 15.

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