两种常用消毒液冲洗后结膜囊菌群检验结果的Meta分析  

Meta analysis of the bacteria culture results after conjunctiva sac irrigation by two commondisinfectant

作　　者：金佩瑶[1] 邹海东[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080

出　　处：《中华检验医学杂志》2013年第7期625-629,共5页Chinese Journal of Laboratory Medicine

摘　　要：目的通过比较聚维酮碘和庆大霉素冲洗后结膜囊菌群检验结果和分析两种冲洗液的不适症状来为眼科术前常规消毒规范化提供依据。方法检索Pubmed、Embase、Cochrane Library、万方数据库、CNKI数据库和维普数据库，筛查得到6篇比较聚维酮碘和庆大霉素冲洗后结膜囊菌群检验结果的随机临床试验研究，以冲洗前后的结膜囊细菌培养结果为效应指标，用随机效应模型对入选文献的数据进行Meta分析，并且对两种冲洗液引起的不适症状进行描述性对比分析。结果冲洗前结膜囊细菌以革兰阳性球菌为主，最常见的是表皮葡萄球菌和金黄色葡萄球菌，检出率为30．5％（226／740）和2．4％（18／740），构成比为65．5％和5．2％。冲洗后细菌数量显著减少，但不能完全清除。聚维酮碘和庆大霉素结膜囊冲洗的除菌效果无明显差异，相对危险度（RR）的加权平均估计值为0．51，95％可信区间为（0．25，1．06），P=0．07。冲洗后聚维酮碘较庆大霉素不适症状多见，但调整浓度后患者可以接受，不影响手术。结论聚维酮碘和庆大霉素结膜囊冲洗消毒效果无明显差异。低浓度聚维酮碘的不适症状轻。聚维酮碘较庆大霉素对结膜囊菌群种类更有针对性。提倡使用聚维酮碘溶液进行术前常规结膜囊消毒。Objective To provide strong evidence for sterilization standardization by comparing the results of bacteria culture after conjunctiva sac irrigation by gentamicin and povidone-iodine （ PVI ） and analyzing the sterilization effect of these two common disinfectant. Methods Six randomized control trials comparing the sterilization effect between gentamicin and PVI in conjunctiva sac irrigation were retrieved through the following databases：Pubmed, Embase, Cochrane Library, WANFANG DATA, CNKI and VIP database. Relative Risk（RR） was set as the effect indexes to evaluating the conjunctiva sac bacterial-culture results before and after irritation. The data of these articles were processed with Meta analysis by random model. The side effects of both dilutions were also compared using the descriptive analysis. Results Before irrigation, bacteria in the sac were mostly gram-positive coccus, among which Staphylococcus epidermidis and Staphylococcus aureus were most common. The detection rate of these two bacteria were 30. 5% （226/740） and 2. 4% （18/740） , and the constituent ratio were 65.5% and 5.2% respectively. After irrigation, the number of the bacteria was decreased dramatically, but could not be totally eliminated. There was no significant difference in sterilization effect between gentamiein and PVI after eonjunctiva sac irrigation. The weighted average value of RR was 0. 51 with 95% confidence interval （CI） in （0. 25, 1.06） , P = 0. 07. Comparing to gentamicin, PVI was less comfortable after conjunetiva sac irrigation, but when the concentration was regulated, it would be acceptable by patients and didn＇t affect surgeries. Conclusions There was no significant difference in sterilization effect between gentamicin and PVI in conjunctiva sac irrigation. The side effect of PVI was minor in low concentration. PVI is more specific to the bacteria species than gentamicin. Using PVI was recommended in preoperation sterilization.

关 键 词：聚维酮碘 庆大霉素类 结膜 灌洗 术前用药法 META分析 

分 类 号：R779.1[医药卫生—眼科]