白内障术前不同浓度聚维酮碘结膜囊冲洗对角膜上皮影响的研究  

Clinical effects of conjunctival sac flushing using different concentration of povidoneiodine on corneal epithelium before cataract surgeries

作　　者：顾雪莲[1] 雷鸣[2] 

机构地区：[1]中国上海市第七人民医院手术室,200137 [2]中国上海市第七人民医院重症医学科,200137

出　　处：《国际眼科杂志》2015年第10期1808-1810,共3页International Eye Science

基　　金：上海市浦东新区卫生局立项项目(No.PW2012A-16)~~

摘　　要：目的:确定一个白内障术前安全使用聚维酮碘(PVP-I)消毒冲洗的最佳浓度,为临床眼部手术工作提供科学依据。方法:将2012-10/2014-10上海市第七人民医院行白内障超声乳化联合人工晶状体植入手术患者62例随机分为0.25g/L PVP-I组(Ⅰ组)和5g/L PVP-I(Ⅱ组)两个浓度组,分别进行不同浓度PVP-I研究分析。结果:两组患者冲洗后结膜囊杀菌均取得明显效果,但两组之间比较差异无统计学意义(P>0.05)。两组患者均未发生眼内炎,冲冼后观察角膜状况,均无严重结膜充血、角膜水肿等严重并发症,Ⅱ组角膜上皮稍有点状脱落,两组比较差异有统计学意义(P<0.05)。两组患者冲洗后Ⅰ组患者不适率为12.5%,Ⅱ组为40%,两组不适率比较差异有统计学意义(P<0.05)。结论:0.25g/L浓度的PVP-I术前冲洗消毒结膜囊可有效抑制清除结膜囊细菌,降低对角膜上皮的影响从而减少术后并发症的发生,细菌阳性率降低,舒适度增加,为手术区域提高了适宜环境。AIM：To determine the most optimal concentration of the safe usage of povidone- iodine （ PVP- I ） in the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work. METHODS： Sixty - two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0. 25g/L PVP-I group （Ⅰ） and 5g/L PVP - I group （ II ） . Sterilizing effect and the complications postoperative were analyzed. RESULTS：The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant（P〉0. 05）. No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupII, and the difference was statistically significant （P〈0. 05） betweenthe two groups. After rinsing, discomfort rate of groupⅠ was 12. 5%, and 40% of group II. The difference of discomfort rate between the two groups was statistically significant （P〈0. 05）. CONCLUSION：Using 0. 25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

关 键 词：结膜囊 聚维酮碘 冲洗 角膜上皮 

分 类 号：R779.6[医药卫生—眼科]