白内障围术期用药与术后感染相关性探讨简

目的分析结膜囊菌群分布,探讨白内障围术期用药及用药途径与眼内感染的相关性,为防治白内障术后感染、规范围术期抗菌药物的应用提供依据。方法选择2011年8月～2012年7月佛山市顺德区桂洲医院眼科收治的白内障患者205例为研究对象,将其分为单纯结膜囊用药组（A组）和结膜囊用药联合全身用药组（B组）,术前均进行结膜囊细菌培养及药物敏感试验,A组给予眼部局部敏感抗菌素滴眼液。B组在此基础上予以全身应用抗生素,比较两种用药方式术后感染情况。结果两组患者共205例（眼）,术后观察2～4d,两组患者均未发生跟内感染。结论尽管白内障术前患者结膜囊内大多存在致病性细菌和条件致病菌,但通常只需通过眼部局部敏感药物使用,即可达到预防术后眼内感染的效果,从而避免滥用抗生素,减少抗生素耐用性的产生。

Study on correlation between perioperative antibiotics administration and postoperative intraocular infection of senile cataract

Objective To analyze the distribution of the bacterial flora in conjunctival sac, discuss the correlation between perioperative antibiotics administration and intraocular infection of senile cataract, and to provide the basis for prevention of postoperative infection and specification perioperative application of antimicrobial agents. Methods 205 eyes with senile cataract from August 2011 to July 2012 in Ophtalmology Department of Shunde District Guizhou Hospital of Foshan City were selected as the study objects, they were randomly divided into simple conjunctival sac medication group （group A） and conjunctival sac medicine combined systemic administration group （group B）, patients of two groups were given preoperative bacterial culture of conjunetival sac and antibiotics sensitivity test. Patients in group A were given local administration of external sensitive antibiotic eye drops, whereas the patients in group B were were given systemic administration of intravenous antibiotics administration in addition. The rate of postoperat!ve infection of two groups were compared. Results Two groups with total 205 cases （eyes）, postoperative observation for 2- 4 days, however, there was no patient underwent postoperative intraocular infection either in group A or in group B. Conclusion Although there are various pathogenic bacteria and conditions of pathogenic bacteria in eonjunctival sac of patients with senile cataract before surgery treatment, the using of external sensitive antibiotic eye drops alone is sufficient for eutrepisty of cataract patient to prevent the postoperative intraocular infection, and avoid the abuse of antibiotics, reduce the durability of antibiotics.