LASIK术前眼表细菌培养及围手术期用药分析  

Bacteria Culture results of eye surface before LASIK and analysis of perioperative antibiotic treatment

作　　者：张建华[1] 郑磊[1] 高鹏[1] 陈倩[1] 王倩[1] 雷蕾[1] 王红英[1] 

机构地区：[1]第二军医大学附属长海医院眼屈光外科中心,上海市200433

出　　处：《眼科新进展》2008年第6期438-440,共3页Recent Advances in Ophthalmology

摘　　要：目的观察分析近视人群结膜囊、睑缘带菌及药物敏感状况,指导LASIK手术前后抗生素的应用。方法收集200例(400眼)LASIK术前患者用药前和使用泰利必妥滴眼液或托百士滴眼液后1d、3d、5d的结膜囊及睑缘标本,进行细菌培养和药物敏感试验,再按照性别、年龄、角膜接触镜配戴史及用药情况进行分组统计。结果用药前结膜囊及睑缘细菌培养阳性89眼,均为革兰阳性球菌,阳性率22.25%,其中表皮葡萄球菌占80.9%,金黄色葡萄球菌占12.4%,溶血性葡萄球菌占6.7%.带菌率与配戴角膜接触镜及性别无关,与年龄有关,年龄大者带菌率高。药物敏感试验本组细菌对丁胺卡那、庆大霉素、利福平、妥布霉素及氧氟沙星的敏感性优于其他抗生素。用药后结膜囊细菌培养均为阴性,睑缘细菌培养阳性率2.2%.结论LASIK围手术期局部合理应用抗生素,对于防治LASIK术后感染是有效且必要的。Objective To investigate the culture results of bacteria and it＇ s antibiotic sensitivity of conjunctival sac and palpebral margin of myopic patients so as to guide the perioperative using of antibiotics in LASIK. Methods Four hundred conjunctival specimens from 200 consecutive patients undergoing LASIK were cultured and identified before medication and after using Tarivid or Tobrex antibiotic drops 1 day,3 days and 5 days,and was divided into groups by sex,age,wearing corneal contact lens and medication. Results The cultured positive results were found in 89 eases （ 22. 25% ） before using antibiotics and all were Gram-positive bacteria. In positive cultures, Staphylococcus epidermidis was 80.9%, Staphylococcus aureus was 12.4% and Staphylococcus haemolyticus was 6.7%. The rate has nothing with wearing corneal contact lens and sex. The more the age was, the higher the cultured positive rate. The Amikacin, Gentamicin, Rifampicin, Tobramycin and Ofloxacin were more sensitive to antibiotic sensitivity test than others. The cultured results were negative in conjunctival sac and positive 2.2% in palpebral margin after medication. Conclusion It is effective and essential touse antibiotic drops reasonably in perioperative medication of LASIK.

关 键 词：准分子激光原位角膜磨镶术 结膜 细菌培养 药敏实验 预防性用药 

分 类 号：R777[医药卫生—眼科]