白内障术前睑板腺特殊处理对结膜囊微生物影响分析  

Influence of special treatment of meibomian gland on the conjunctival sac＇s microorganisms before cataract surgery

作　　者：许金凤[1] 马华锋[1] 周希瑗[1] 许燕[1] 

机构地区：[1]重庆医科大学附属第二医院眼科,重庆400010

出　　处：《中国实用眼科杂志》2012年第12期1437-1442,共6页Chinese Journal of Practical Ophthalmology

基　　金：重庆市卫生部医药卫生科技项目（2011-2-171）

摘　　要：目的前瞻性研究白内障术前通过眼睑热敷、按摩及清洁睑缘等睑板腺的特殊处理对结膜囊微生物状态的影响，寻求更安全的内眼手术术前准备方法。方法将87例90只眼拟行白内障手术患者随机分为A（空白组：未做任何处理之前）、13（对照组：术前使用抗生素眼液滴眼、剪眼睫毛、生理盐水冲洗泪道及结膜囊等常规术前准备）、C（处理组：常规术前准备＋睑板腺特殊处理）三组，分别为25例26只眼、29例29只眼、33例35只眼，A组于人院时，B、c两组于手术开始及术毕两个时间点分别采集结膜囊标本，送检行微生物培养。结果（1）结膜囊微生物培养阳性率：A组为53．85％，B组与C组手术开始及术毕两个时间点的阳性率分别为10．34％、27．59％与2．86％、5．71％。C组结膜囊微生物培养阳性率明显降低，与A组、B组组间差异均有统计学意义（P〈0．05）。（2）结膜囊微生物培养阳性率与术前抗生素眼液使用天数、术前睑板腺处理时间、手术持续时间长短差异均无统计学意义（P〉0．05）。（3）结膜囊微生物培养菌种：共培养出阳性菌28株，5种菌属。未培养出真菌。结论（1）正常人群中结膜囊存在一定细菌；术前使用抗生素眼液滴眼、剪眼睫毛、生理盐水冲洗泪道及结膜囊等常规术前准备可以减少结膜囊微生物培养阳性率；对睑板腺特殊处理后可以更进一步降低结膜囊微生物培养检出率。（2）白内障术前增加对睑板腺的特殊处理可以在减少局部使用抗生素眼液时间的情况下，同样达到有效清洁术野、减少结膜囊微生物的作用，从而起到降低术后眼内炎风险的作用。Objective To study the effect of the conjunctival sac＇s microbial condition after spe- cial treatment of meibomian gland including eye lid fomentation, massage and clean palpebral mar- gin, to explore more and more safe preparation before ocular operation. Methods Eighty-seven cas- es of 90 eyes that needed the cataract surgery were divided into three groups randomly. A （blank group： without any treatments）, B （control group： routine preparation preoperative including use of an- tibiotic eye drops ＋ cut lashes ＋ rinse tractus lacrimalis and conjunctival with isotonic Na chloride）, C （treatment group： routine preparation preoperative ＋ special treatment of meibomian gland）. There were 25 cases of 26 eyes, 29 cases of 29 eyes, 33 cases of 35 eyes in each group respectively. Specimens of the conjunctival sac were collected at the admission （group A）, at the start of the sur- gery and at the end of the surgery （group B and C）, and sent to bacterial culture. Results Microbi- al culture positive rate of the conjunctival sac： in group A was 53.85%, at the start of the surgeryand at the end of the surgery, the positive rates were 10.34%, 27.59% and 2.86%, 5.71% respective- ly in the group B and group C. Microbial culture positive rate of the conjunctival sac was de- creased obviously in the group C （meibomian gland received the special treatment）, there was statisti- cal significance （P 〈0.05）. There wasn＇t statistical significance between the microbial culture positive rate of the conjunctival sac and date of antibiotic eye drops used before surgery, time of the treat- ment of meibomian gland, duration of the surgery （P 〉0.05）. The kinds of the microbial culture were 28 stocks and 5 genera totally, fungus was not detected. Conclusions There is a certain bacte- ria in the conjunctival sac of the normal population; routine preparation preoperative can reduce the microbial culture positive rate of the conjunctival sac, and reduce further after special treatment of the m

关 键 词：白内障 睑板腺 结膜囊 微生物培养 术前准备 

分 类 号：R779.66[医药卫生—眼科]