白内障术前结膜囊预防性用药后细菌检测分析  

Analysis of bacterial culture after different antibiotics and pre-postoperative conjunctiva sac of cataract patients

作　　者：管建花[1] 吴强[1] 胡萍[1] 宋蓓雯[1] 陆斌[1] 张谊[1] 

机构地区：[1]上海交通大学附属第六人民医院眼科,上海200233

出　　处：《中国实用眼科杂志》2007年第12期1288-1291,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨白内障待手术患者术前使用抗生素前后及术后结膜囊细菌学状态,了解不同药物对结膜囊的抑菌效果,为临床治疗提供参考依据。方法调查200例结膜囊外观清洁、无眼部炎症、泪道冲洗通畅的白内障住院患者,分别于入院未用抗生素眼液点眼前、手术消毒前运用不同抗生素眼液点眼及术后第1天拆开眼垫换药前进行结膜囊细菌培养。结果术前未使用抗生素眼液点眼前的结膜囊细菌培养阳性率为35.5%（7l/200）,分为四组予以林可霉素,氧氟沙星,左氧氟沙星,妥布霉素点眼后,结膜囊细菌的清除率分别为70.59%（12/17）、94.74%（18/19）、100%（16/16）、89.47%（17/19）,术后第1天拆开眼垫后结膜囊的细菌培养阳性率为6%（12/200）。革兰阳性球菌最多见,约为81.69%（58/71）,革兰阴性杆菌其次。结论结膜囊可以有各种细菌存在。使用不同抗生素后结膜囊细菌培养率有一定的区别,几种药物的抑菌效果有差异。使用抗生素眼液后及白内障术后第1天都有结膜囊细菌存在,提示白内障术前及术后均应加强抗生素眼液点眼,以减少术后眼内炎的发生。Objective To investigate the condition of bacteriology in the conjunctival sac of cataract patients, before and after cataract operation, after using different antibiotics eye drops for researching bacteriostasis. Methods 200 cataract patients with normal appearance of conjunctival sac and without ocular inflammation were studied. The samples were taken from the conjunctival sac before the use of antibiotics eye drops ,before operation sterilization and at the first postoperative day. All samples were cultured for bacteria. Results Before the use of antibiotics eye drops the bacterial growth rate was 35.5%（71/200）.The clearance rate is 70.59%（12/ 17）,94.74% （18/19）, 100% （16/16）, 89.47% （17/19） after the use of.Lincomycin, Ofloxacin, Levofloxacin, Tobramicin. But the rate was 6% in the samples taken from conjunctival sac at the first postoperative day. Gram - positive cocci （ G＋C）,81.69 % （58/71）was predominant bacteria in the conjunctival sacs and Gram -negative bacilli （G-B） second. Conclusion There were all kinds of bacteria exist in the normal conjunctival sac. The bacterial growth rate was disparity after using different antibiotics. Although there were using antibiotics before operation, bacteria appear in the conjunctival sac before disinfection and at the first postoperative day. This suggests that the use of antibiotics should be enhanced before and after operation in order to avoid endophthalmitis.

关 键 词：白内障 结膜囊 抗生素 细菌培养 

分 类 号：R722.13[医药卫生—儿科]