| 边俊杰,蒋慧中,张 健,戴惟葭,刘大川.白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素及其预测模型构建[J].,2024,(3):454-458 |
| 白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素及其预测模型构建 |
| Influencing Factors of Infective Endophthalmitis after Cataract Phacoemulsification Combined with Intraocular Lens Implantation and Construction of Prediction Model |
| 投稿时间：2023-06-27 修订日期：2023-07-23 |
| DOI：10.13241/j.cnki.pmb.2024.03.010 |
| 中文关键词: 白内障 超声乳化 人工晶状体植入 感染性眼内炎 预测模型 |
| 英文关键词: Cataract Ultrasonic emulsification Intraocular lens implantation Infectious endophthalmitis Prediction model |
| 基金项目:北京市科委首都临床特色应用研究与成果推广项目（Z17110001017029） |
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| 中文摘要: |
| 摘要 目的：探讨白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素及其预测模型构建。方法：回顾性分析2015年2月至2023年2月我院收治的12308例白内障患者的临床资料，所有患者均行白内障超声乳化联合人工晶状体植入手术治疗，统计术后感染性眼内炎发生情况。采用多因素Logistic回归模型分析白内障超声乳化联合人工晶状体植入术后感染性眼内炎的影响因素，根据回归模型构建预测模型，采用受试者工作特征（ROC）曲线验证预测模型的预测效能。结果：12308例患者中发生感染性眼内炎32例（0.26%）。单因素分析结果显示感染组年龄≥70岁、合并糖尿病、手术时间≥30 min、手术切口≥3.2 mm、植入PMMA人工晶体、后囊膜破裂比例高于对照组（P＜0.05），术中预防性使用抗生素、晶状体后冲洗比例低于对照组（P＜0.05）。多因素Logistic回归模型分析显示年龄≥70岁、合并糖尿病、后囊膜破裂、植入PMMA人工晶体是白内障超声乳化联合人工晶体植入术后感染性眼内炎的危险因素（P＜0.05），术中预防性使用抗生素、晶状体后冲洗是保护因素（P＜0.05）。以Logistic回归模型结果保留变量构建预测模型，Hosmer-Lemeshow拟合优度检验P＞0.05。ROC分析该模型预测白内障超声乳化联合人工晶体植入术后感染性眼内炎的曲线下面积为0.832，灵敏度、特异度分别为81.25%、85.12%。结论：年龄≥70岁、合并糖尿病、后囊膜破裂、植入PMMA人工晶状体是术后感染性眼内炎的危险因素，术中预防性使用抗生素、晶状体后冲洗可降低感染性眼内炎发病风险。根据多因素Logistic回归分析构建的预测模型对感染性眼内炎的预测能效较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the influencing factors of infective endophthalmitis after cataract phacoemulsification combined with intraocular lens implantation and establish a predictive model. Methods: A retrospective analysis was performed on the clinical data of 12,308 cataract patients admitted to our hospital from February 2015 to February 2023, and all patients underwent phacoemulsification of cataract combined with intraocular lens implantation surgery, and the occurrence of postoperative infectious endophthalmitis was statistically counted. Multivariate Logistic regression analysis was conducted to analyze the influencing factors of infective endophthalmitis after cataract phacoemulsification combined with intraocular lens implantation. The predictive model was constructed according to the regression model, and the predictive efficiency of the predictive model was verified by receiver operating characteristic (ROC) curve. Results: Infectious endophthalmitis occurred in 32 of 12 308 patients (0.26%). The results of univariate analysis showed that the infection group was older than the control group (P<0.05), the proportion of diabetes mellitus, operation time≥30 min, incision≥3.2 mm, PMMA implantation, posterior capsule rupture was higher than the control group (P<0.05), and the proportion of preventive antibiotic use and post-lens irrigation was lower than the control group (P<0.05). Multivariate Logistic regression analysis showed that age≥70 years old, combined diabetes mellitus, posterior capsule rupture and PMMA intraocular lens implantation were risk factors for infective endophthalmitis after cataract phacoemulsification combined with intraocular lens implantation(P<0.05), and intraoperative antibiotic use and post-lens irrigation were protective factors (P<0.05). The prediction model was constructed with the retained variables of Logistic regression, and the Hosmer-Lemeshow goodness of fit test was P>0.05. ROC analysis predicted the area under the curve of infective endophthalmitis after phacoemulsification combined with intraocular lens implantation was 0.832, and the sensitivity and specificity were 81.25% and 85.12%, respectively. Conclusion: Age≥70 years old，combined diabetes mellitus, posterior capsule rupture and implantation of PMMA intraocular lens are risk factors for postoperative infectious endophthalmitis. Intraoperative antibiotic use and post-lens irrigation can reduce the risk of infectious endophthalmitis. The prediction model based on multivariate Logistic regression analysis has better energy efficiency in predicting infectious endophthalmitis. |
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