白内障超声乳化术中灌注液加入头孢呋辛对房水细菌污染的控制作用  

Control actions of intraoperative cefuroxime in irrigating solutions on aqueous humor contamination after phacoemulsification of cataract

作　　者：王玉倩 黄钰森[2] WANG Yu-Qian;HUANG Yu-Sen(From the Medical College of Qingdao University,Qingdao 266071,Shandong Province,China;State Key Laboratory Cultivation Base,Shandong Province Key Laboratory of Ophthalmology,Shandong Eye Institute,Shandong Academy of Medical Sciences ,Qingdao 266071,Shandong Province,China)

机构地区：[1]青岛大学医学院,山东省青岛市266071 [2]山东省眼科研究所,省部共建-山东省眼科学重点实验室,山东省青岛市266071

出　　处：《眼科新进展》2019年第8期749-753,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81670839);山东省重点研发计划(编号:2018CXGC1205)~~

摘　　要：目的评估白内障超声乳化术中灌注液加入头孢呋辛对房水细菌污染的控制作用。方法选取2017年5月至8月在青岛眼科医院接受白内障超声乳化手术治疗的患者为研究对象,根据术中灌注液的不同分为两组,对照组99例(102眼)使用平衡盐溶液灌注液;试验组93例(100眼)使用含头孢呋辛(1.5 g·L^-1)的平衡盐溶液灌注液。两组患者分别于入院时(未局部应用抗菌药物前)、术前(聚维酮碘冲洗结膜囊后)行结膜囊细菌培养,于手术结束时行房水细菌培养,并对两组患者结膜囊及房水细菌培养结果进行比较。结果入院时,对照组与试验组结膜囊细菌培养阳性率为50.00%和51.00%,差异无统计学意义(χ^2=0.020,P=0.887);术前,对照组与试验组结膜囊细菌培养阳性率为25.5%和27.0%,差异无统计学意义(χ^2=0.059,P=0.807);手术结束时,对照组与试验组房水细菌培养阳性率为5.9%和0,差异有统计学意义(F=6.062,P=0.029)。结论使用含头孢呋辛(1.5 g·L^-1)的灌注液能减少白内障超声乳化术的房水细菌污染。Objective To assess the effect of intraoperative cefuroxime in irrigating solutions on contamination of anterior chamber(AC) aspirates during phacoemulsification.Methods Patients undergoing phacoemulsification of cataract in the Qingdao eye hospital during May 2017 and August 2017 were enrolled in this study,and were divided into two groups according to different irrigation used during the operation.In the control group,99 patients(102 eyes) received balanced salt perfusion solution,while in the experimental group,93 patients(100 eyes) received balanced salt perfusion solution with cefuroxime(1.5 g·L^-1).Conjunctival bacterial cultures were conducted in all patients at the time of admission(before use of topical antibiotics),and before surgery(after povidone iodine rinsing conjunctival sac);at the end of operation,aqueous humor samples were taken and sent for enrichment cultures.Bacteriological culture positive rates of conjunctival sac and AC aspirate were compared.Results At the time of admission,the positive rate of conjunctival sac culture in control group and experiment group was 50.00% and 51.00%,respectively,and there was no significant difference between two groups(χ^2=0.020,P=0.887).Before surgery,the positive rate of conjunctival sac culture was 25.5% and 27.0%,respectively,and there was no significant difference between two groups(χ^2=0.059,P=0.807).At the end of operation,the positive rate of AC aspirate culture in control group and experiment group was 5.9% and 0,respectively,and there was statistically significant difference between two groups(χ^2=6.062,P=0.029).Conclusion The use of irrigation fluid containing cefuroxime(1.5 g·L^-1) during phacoemulsification can reduce the microbial contamination of aqueous humor.

关 键 词：灌注液 头孢呋辛 房水细菌污染 超声乳化白内障吸出术 

分 类 号：R779.66[医药卫生—眼科]