5%安尔碘Ⅲ型稀释液对白内障术前结膜囊病原菌的消毒效果

目的 对比5%安尔碘Ⅲ型稀释液与0.5%妥布霉素稀释液用于白内障术前结膜囊冲洗的消毒效果.方法 选择90例行白内障超声乳化联合人工晶状体植入术的患者共102只眼,术眼先用0.3%左氧氟沙星滴眼液点眼3d,再随机分入安尔碘组与妥布霉素组,于冲洗前后,取结膜囊拭子送检进行细菌培养及药物敏感性试验;并在手术与术后随防中观察术眼眼表改变.结果 结膜囊冲洗前细菌培养阳性率:安尔碘组为20%(10只眼),妥布霉素组为17.3%(9只眼);冲洗后阳性率:安尔碘组为0;妥布霉索组为5.8%(3只眼),冲洗后两组阳性率对比无统计学意义.冲洗前后细菌培养阳性中以表皮葡萄球菌占多数.所有病人术中及术后随防半年均未观察到角结膜药物毒性或过敏反应;两组病人基础泪液分泌(Sit)与泪膜破裂时间(BuT)在术后1d对比无统计学差异;应用安尔碘冲洗结膜囊的白内障术后病人术后7d、30d、半年的Sit与BUT值与文献报道接近;培养的细菌对部分抗生素存在耐药现象.结论 5%安尔碘Ⅲ型稀释液可以安全、有效地应用于白内障术前结膜囊消毒.

Sterilizing effects of 5% Anerdian type 3 disinfectant dilution used in conjunctival sac before cataract surgery

Objective To compare the sterilizing effects of 5% Anerdian type 3 disinfectant dilution and 0.5% tobramycin solution used in conjunctival sac before cataract surgery. Methods Ninety cataract pa-tients ( 102 eyes) who had undergone phacoemuisification aspiration with intraocular lens insertion received 0.3% levofloxacin ophthalmic solution in the operative eye for three days before surgery and were divided into two groups randomly: the patients in one group were treated with diluted Anerdian eyewash,and those in the second group with diluted Tobramycin eyewash,immediately before the surgery. Conjunctival cultures were obtained from the operative eye before and after eyewash to observe the topical complication. Results Con-junctival cultures were positive for 10 (20%) of the Anerdian-treated eyes and 9 (17.3%) of the to-bramycin-treated eyes before eyewash. While after eyewash,the incidence of positive cultures decreased for both groups. No culture-positive was found in the Anerdian-treated group compared with 3 (5.8%) eyes in the tobramycin-treated group. There was no significant difference in culture positivity between two groups. The cultures principally showed growth of Staphylococcus epidermidis. And we disclosed no toxic or allergic reac-tion in both groups 6-month post-operatively. No significant difference were seen in BUT and Sit between two groups at day 1 postoperatively. The checking data of Sit and BUT on 7-day,30-day and 6-month postopera-tively in Anerdian eyewash patient is closed to reported. Some bacterial strains were resistance to antibiotics.Conclusion Irrigation of the conjunctival sac with a 20-fold-diluted Anerdian type 3 solution immediately pri-or to cataract surgery is recommended.