细菌性角膜溃疡病原学特征及0.01%次氯酸水溶液联合左氧氟沙星的疗效观察  

Etiological characteristics of bacterial corneal ulcer and analysis of the therapeutic effects of 0.01%hypochlorous acid aqueous solution combined with levofloxacin

作　　者：符乃方 庄耿刚 陈诗海 Fu Naifang;Zhuang Genggang;Chen Shihai(Ophthalmology Department of Wenchang People’s Hospital,Hainan Province,Wenchang 571300,China)

机构地区：[1]文昌市人民医院眼科,海南文昌571300

出　　处：《海军医学杂志》2022年第1期55-59,共5页Journal of Navy Medicine

基　　金：海南省卫生健康行业科研项目(20A200367)。

摘　　要：目的探究细菌性角膜溃疡病原学特征及0.01%次氯酸水溶液联合左氧氟沙星治疗的效果。方法回顾性分析文昌市人民医院眼科2019年1月至2021年1月收治的107例细菌性角膜溃疡患者的临床资料。通过角膜溃疡刮片或术中切除的角膜溃疡组织标本对其感染病原菌谱的分布特征进行分析;107例患者依据不同治疗方式分为A、B组,A组58例患者采取0.01%次氯酸水溶液联合左氧氟沙星进行治疗,B组49例患者单纯使用左氧氟沙星治疗,对比2组患者的临床疗效、临床指标及治疗前后临床症状评分差异。结果(1)107例细菌性角膜溃疡中,细菌培养呈阳性20例(18.69%),无菌生长87例(81.31%),其中以表皮葡萄球菌(4.67%)、金黄色葡萄球菌(2.80%)、铜绿假单胞菌(2.80%)、链球菌(2.80%)为主;(2)A组患者治疗总有效率为96.55%(56/58),显著高于B组的83.67%(41/49),差异有统计学意义(P<0.05);(3)A组患者治愈时间、住院时间、结膜充血消失时间、上皮生长时间均显著低于B组,最佳矫正视力显著高于B组(P<0.05);(4)治疗后,2组患者的异物感、疼痛、前房积脓、畏光、结膜充血、分泌物、睫状充血、溃疡面积评分均降低,且A组显著低于B组(P<0.05)。结论细菌性角膜溃疡影响患者视力且影响其日常生活。采取微生物学检测病原菌是有利于患者恢复视力的有效措施;0.01%次氯酸水溶液联合左氧氟沙星对治疗细菌性角膜溃疡疗效理想,能够有效改善患者临床症状、促进伤口愈合并恢复视力。Objective To investigate the pathogenic characteristics of bacterial corneal ulcer and the therapeutic effects of 0.01%hypochlorous acid aqueous solution combined with levofloxacin.Methods A retrospective analysis was made on the clinical data of 107 patients with bacterial corneal ulcer who received treatment in the Department of Ophthalmology of the hospital from Janu⁃ary 2019 to January 2021.The distribution features of the spectrum of infection pathogens were analyzed through corneal ulcer scrap⁃ing or intraoperative corneal ulcer tissue specimen.107 patients were divided into groups A and B,depending on different treatment methods.58 patients in group A were treated with 0.01%hypochlorous acid aqueous solution combined with levofloxacin,while anoth⁃er 49 patients in group B were simply treated with levofloxacin.Clinical efficacy,related medical indicators and clinical symptom scores before and after treatment were compared between the 2 groups.Result(1)Among the 107 patients with bacterial corneal ul⁃cer,17(18.69%)were positive and 90(81.31%)were negative in bacterial culture.In the 20 positively⁃detected patients,the domi⁃nant bacteria were Staphylococcus epidermidis(4.67%),Staphylococcus aureus(2.80%),Pseudomonas aeruginosa(2.80%)and Strep⁃tococcus(2.80%).(2)The total effective rate of group A was 96.55%(56/58),which was significantly higher than 83.67%(41/49)in group B,with statistical significance(P<0.05).(3)The healing time,hospitalization length,disappearance time of conjunctival hyper⁃emia,and epithelial growth time in the patients of group A were significantly lower than those in the patients of group B,and the best corrected visual acuity was significantly higher than that in the patients of group B(P<0.05).(4)After treatment,the scores of foreign body sensation,pain,anterior chamber empyema,photophobia,conjunctival hyperemia,secretion,ciliary hyperemia and ulcer area all decreased in the patients of the 2 groups,with those of group A being significantly lower than those of group B(P

关 键 词：细菌性角膜溃疡 病原学 次氯酸 左氧氟沙星 

分 类 号：R772.21[医药卫生—眼科]