玻璃体腔注射曲安奈德和万古霉素防治眼球穿通伤并发症实验研究  

Treament of complications of penetrating ocular injury with intravitreal triamcinolone and vancomycin injection in a rabbit model

作　　者：彭燕一[1] 招志毅[1] 

机构地区：[1]广西桂林医学院附属医院眼科,桂林541001

出　　处：《中国实用眼科杂志》2009年第1期44-47,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金基金项目：广西自然科学基金（桂科自0640191）

摘　　要：目的 外伤性增生性玻璃体视网膜病变（proliferative vitreoretinopathy，PVR）和细菌性眼内炎是眼球穿通伤常见的并发症。在外伤性出血性眼球穿通伤动物模型中，观察玻璃体腔注射曲安奈德和万古霉素对眼内炎症、感染及外伤性PVR的抑制效果。方法建立外伤性出血性眼球穿通伤动物模型。随机分为生理盐水组、曲安奈德组、万古霉素组、联合用药（曲安奈德＋万古霉素）组四组。通过裂隙灯显微镜观察眼前节炎症情况，眼前节炎症2级以上且持续超过1周以上者行玻璃体腔微生物学培养；直接眼底镜观察外伤性PVR情况。结果联合用药组外伤性PVR程度、眼前节炎症程度都低于生理盐水组、万古霉素组；生理盐水组、曲安奈德组各发生细菌性眼内炎2例（20％）；万古霉素组、联合用药组未见细菌性眼内炎的发生。结论在外伤性出血性眼球穿通伤动物模型中，玻璃体腔注射曲安奈德和万古霉素能降低外伤性PVR程度和减低眼内炎症、感染的发生率。Objective Both proliferative vitreoretinopathy （PVR）and bacterial endophthalmitis are the most frequent complications of penetrating ocular injury.we observed the rate of confronted infection and the degree of PVR and intraocular inflammation after injecting triamcinolone and vancomycin in vitreous in rabbit model eyes of hemorrhagic penetrating ocular injury.Methods All right eyes of 40 New Zealand albino rabbits were created as experimental rabbit model eyes of hemorrhagic penetrating ocular injury and all left eyes were intact.The rabbits were divided into phosphate buffered saline group,triamcinolone group, vancomycin group triamcinolone combination with vancomycin group randomly.The extent of inflammation in anterior segment of eye were estimated by Slit-lamp microscope examination.Microbiology examination in vitreous must be done in these eyes in which the extent of inflammation in anterior segment exceeded grade 2 and had lasted 1 week.Degree of PVR in vitreous were estimated by Direct funduscopy examination.Results The extent of intraocular inflammation ,degree of PVR in triamcinolone combination with vancomycin group are lower than both phosphate buffered saline group and vancomycin group.There were 2 eyes （occupying 20% ） confronted endophthalmitis in both phosphate buffered saline group and triamcinolone group respectively; There were not eyes confronted endophthalmitis in both vancomycin group and triamcinolone combination with vancomycin group.Conclusions The therapeutics of intravitreal triameinolone combination with vancomycin injection can decrease both the incidence of bacterial endophthalmitis and the extent of intraocular inflammation, in addition to decreasing the degree of PVR.

关 键 词：眼球穿通伤 并发症/药物疗法 曲安奈德/治疗应用 万古霉素 治疗应用 动物实验 

分 类 号：R776.05[医药卫生—眼科] R779.12[医药卫生—临床医学]