五水头孢唑林钠联合左氧氟沙星治疗细菌性角膜炎的临床效果  

Clinical effects of cefazolin sodium pentahydrate combined with levofloxacin eye drops in treatment of bacterial keratitis

作　　者：吴彦超[1] 吴一湘 

机构地区：[1]河北省邢台市眼科医院,054001

出　　处：《临床眼科杂志》2017年第4期346-349,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨五水头孢唑林钠与左氧氟沙星联用治疗细菌性角膜炎的疗效及安全性。方法分析2014年2月至2016年2月间入河北省邢台市眼科医院眼科治疗且被诊断为细菌性角膜炎的患者200例,按患者病例号分为两组:病例号为奇数者归为对照组(n=100),使用左氧氟沙星滴眼液进行治疗7 d;病例号为偶数者归为观察组(n=100),五水头孢唑林钠和左氧氟沙星联用治疗7 d。依据:患者眼睛的异物感、前房积脓情况、疼痛、畏光、结膜及睫状出血、分泌物情况等方面评价治疗前后临床症状的评分;分析对照组与观察组患者的治愈率、不良反应率、患者的预后以及影响预后的因素等。结果经不同方案治疗后,眼睛的异物感、前房积脓、疼痛、畏光、结膜及睫状出血、分泌物多等症状均明显减轻(P<0.05);观察组评分显著优于对照组(P<0.05);观察组7 d治愈率为93.0%显著高于对照组72.0%的治愈率(χ~2=15.27,P<0.01);观察组不良反应率为4.0%显著低于对照组12.0%的不良反应率(χ~2=4.348,P<0.05),不良反应主要为眼部刺痛;观察组的总有效率97.0%明显高于对照组90.0%(χ~2=4.031,P<0.05);对所有患者进行预后因素分析发现:高龄、基础病、照顾者的文化程度和对角膜炎的认识程度、及时治疗的程度均显著影响患者的预后(P<0.05)。结论五水头孢唑林钠联用左氧氟沙星滴眼液治疗细菌性角膜炎疗效显著,症状改善明显,同时加强对细菌性角膜炎患者家属的宣教将对改善患者的预后有重要意义。Objective To evaluate the efficiency and safety of cefazolin sodium pentahydrate combined with levo- floxacin eye drops in the treatment for bacterial keratitis. Methods During February 2014 to February 2016, 200 patients with bacterial keratitis treated in Xingtai Eye Hospital were enrolled and divided into control group （ n = 100 ） and observa- tion group （ n = 100 ）. Patients in control group received levofloxacin eye drops for 7 days, while patients in observation group received cefazolin sodium pentahydrate in addition for 7 days. Clinical symptoms ＆ signs, such as foreign body sen- sations, hypopyon, pain t photophobia, conjunctival congestion, ciliary congestion, secretion, were analyzed. Recovery rate, adverse event rate, prognosis and prognostic effective factors of two groups were also analyzed. Results Symptoms significantly reduced in all patients after treatment （ P 〈 0. 05 ）. Observation group showed better symptom relief than con- trol group （ P 〈 0. 05 ）. The cure rate was 93.0% in observation group, which was significantly higher （ X2 = 15.27, P 〈 0. 01 ）. The incidence of adverse reaction was 4. 0% in the observation group and 12. 0% in the control group （ X2 = 4. 348, P 〈 0.05 ）. The major side effect was stinging eyes. The total efficiency of prognosis was 97.0% in observation group and was significantly higher （ X2 =4. 031, P 〈0.05 ）. Binary logistic regression analysis found factors that affect the prog- nosis including age, underlying comorbidities, primary caretaker＇ knowledge of bacterial keratitis and cultural level and the prompt treatment. Conclusions Application of cefazolin sodium pentahydrate combined with levofloxacin eye drops signifi- cantly improves the efficiency and safety for treatment bacterial keratitis. Meanwhile, strengthening the education of care- taker＇ knowledge of bacterial keratitis will help improve the prognosis of patients.

关 键 词：细菌性角膜炎 五水头孢唑林钠 左氧氟沙星滴眼液 

分 类 号：R772.21[医药卫生—眼科]