白内障手术患者局部用药预防感染的效果分析  

Effect of topical medication for prevention of infections after cataract surgeries

作　　者：向晖[1] 陆伟业 任艳妮[1] 罗碧单 赵玉琴[1] 

机构地区：[1]武警广东总队医院眼科,广东广州510507

出　　处：《中华医院感染学杂志》2016年第11期2562-2564,共3页Chinese Journal of Nosocomiology

基　　金：广东省自然科学基金资助项目(S2013010011916)

摘　　要：目的探讨白内障手术患者局部用药预防感染的效果,为预防白内障手术患者术后感染提供临床依据。方法选取2009年1月-2014年8月1 300例(眼)于医院进行手术治疗的白内障患者,采用随机数字表法分为单纯结膜囊用药组和联合用药组,每组各650例,单纯结膜囊用药组术前、术后眼部局部滴加抗菌药物滴眼液预防感染,联合用药组在此基础上全身应用抗菌药物。结果单纯结膜囊用药组和联合用药组分别有10例和4例发生眼内感染,感染率分别为1.54%和0.62%,两组感染率比较差异无统计学意义;单纯结膜囊用药组细菌培养阳性85例,阳性率为13.08%,其中革兰阳性菌78株,革兰阴性菌7株,分别占91.76%和8.24%,联合用药组细菌培养阳性79例,阳性率为12.15%,其中革兰阳性菌73株,革兰阴性菌6株,分别占92.41%和7.59%,两组细菌培养阳性率差异无统计学意义;表皮葡萄球菌对万古霉素、左氧氟沙星、克林霉素和头孢哌酮/舒巴坦最敏感,敏感率分别为94.87%、89.74%、89.74%和85.90%。结论白内障手术患者围术期眼部局部应用抗菌药物滴眼液,可有效预防术后感染的发生,无需全身预防使用抗菌药物,左氧氟沙星是值得优先考虑的滴眼液。OBJECTIVE To investigate the effect of topical medication for prevention of infections after cataract surgeries.METHODS Totally 1300cases（eyes）of patients with cataract in our hospital from Jan.2009 to Aug.2014 were divided into the single peroperative conjunctival sac medication group and the combined medication group by random number table,650 cases in each group.Patients in the single peroperative conjunctival sac medication group were given eye drops,based on which patients in the combined medication group received intravenously dripped antibiotics.RESULTS Totally 10 cases in the single peroperative conjunctival sac medication group and 4cases in the combined medication group had intraocular infection,with infection rate as 1.54% and 0.62%,without significant difference.Totally 85cases（13.08%）were positive by bacterial culture in the single peroperative conjunctival sac medication group,among which there were 78 strains of gram positive bacteria,7strains of gram negative bacteria,accounting for 91.76% and 8.24%,respectively.Totally 79cases（12.15%）were positive by bacterial culture in the combined medication group,among which there were 73 strains of gram positive bacteria,6strains of gram negative bacteria,accounting for 92.41%and 7.59%,respectively,without significant difference.Staphylococcus epidermidis was the most sensitive to vancomycin,levofloxacin,clindamycin and cefoperazone/sulbactam,with the sensitive rates being 94.87%,89.74%,89.74% and 85.90%.CONCLUSIONPerioperative topical antibiotic eye drops during cataract surgeries is effective in preventing the occurrence of postoperative infection,systemic preventive use of antibiotics is not needed and levofloxacin solution is preferred.

关 键 词：白内障 感染 围术期 局部用药 

分 类 号：R776.1[医药卫生—眼科]