妥布霉素联合聚维酮碘预防白内障术后感染的前瞻性临床研究(1)
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[摘要] 目的 探讨妥布霉素联合聚维酮碘在预防白内障术后感染中的疗效。方法 将拟行白内障手术患者507例(657眼)随机分成两组，分别在术前给予诺氟沙星和妥布霉素滴眼；再将上述两组随机分成三组，分别在术前用生理盐水、林可霉素和聚维酮碘(PVP-I)做结膜囊冲洗，比较冲洗前后及术后第 1天结膜囊细菌培养结果。结果 生理盐水、林可霉素和PVP-1冲洗结膜囊疗效比较，PVP-1具有更好疗效(P<0.05)；经抗生素滴眼加上结膜囊抗生素冲洗后细菌培养阳性率比较，差异有统计学意义(P<0.01)；术后第1天各组结膜囊细菌培养比较，差异有统计学意义(P<0.05)。结论 妥布霉素滴眼液滴眼联合PVP-I结膜囊冲洗能够有效预防白内障术后感染。
[关键词] 白内障；预防感染；聚维酮碘；妥布霉素
[中图分类号] R771 [文献标识码] B [文章编号] 1673-9701(2011)32-73-02
The Prospective Clinical Study of the Effect of Tobramycin and Polyvinylpyrrolidone on Infection Prevention in Cataractsurgery
CHI Qihong WANG Yan CHEN Gangfeng
Department of Ophthalmology，the 1th People’s Hospital of Wenling， Wenling 317500， China
[Abstract] Objective To know the effect of tobramycin and polyvinylpyrrolidone (PVP-I) on infection prevention in cataractsurgery. Methods Firstly，to collect conjunctival sac specimen from eye 657 of cataract sufferers on which scheduled operation will start. Secondly， randomly dividing the sufferers into two groups， separately dripping eyes before operation with levofloxacin and tobramycin， collecting conjunctival sac specimen after dripping as germiculture. Thirdly， dividing the sufferers into three groups and separately washing conjunctival sac with normal saline，cillimycin and PVP-I before operation disinfection， collecting conjunctival sac specimen before and after washing as germiculture，making germiculture on anterior chamberfluid when the operation is over and collecting conjunctival sac specimen one dayafter the operation as germiculture. Results Group C had better effect than Group A or Group B. The tobramycin and polyvinylpyrrolidone group got significant less germiculture positive ratio one day after the operation. Conclusion Tobramycin and polyvinylpyrrolidone have better curative effect in infection prevention of cataractsurgery.
[Key words] Cataract；Infection prevention；Polyvinylpyrrolidone；Tobramycin
细菌性眼内炎是白内障术后最严重的并发症之一，一旦发生将严重影响术后视功能，甚至给患者造成灾难性后果。因此，预防白内障术后细菌性眼内炎的发生是眼科临床工作的重要环节。近年来较多研究发现，细菌性眼内炎的病原菌主要来源于结膜囊，多年来白内障术前结膜囊处理的最主要措施是术前点抗生素滴眼液和结膜囊冲洗。由于目前抗生素种类繁多，给药方式多样，具体的给药方案尚有争议。本研究目的在于探索一种安全、高效的结膜囊给药方法，从而减少白内障术后眼内炎的发生。
1 资料与方法
1.1 一般资料 ......
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