获得性免疫缺陷综合征合并白内障患者经系统高效抗反转录病毒治疗后围手术期感染控制疗效

目的探讨获得性免疫缺陷综合征(AIDS)合并白内障患者经系统高效抗反转录病毒治疗(HAART)后围手术期感染控制的疗效。方法回顾性分析首都医科大学附属北京地坛医院收治的10例AIDS合并白内障患者的术前基本资料及手术前后采取的感染防控方法,探讨其危险因素及防范措施。结果对10例AIDS合并白内障患者行HAART后,CD4+T淋巴细胞计数上升至196~745个/μl,病情稳定,无并发症发生;其中8例患者给予白内障超声乳化术加人工晶体植入术。1例患者合并黄斑前膜,另外1例患者合并视网膜脱离,二者均给予玻璃体切割术+白内障超声乳化术+人工晶体植入术。10例AIDS合并白内障患者术后均未发生感染。结论AIDS合并白内障患者手术前给予系统高效抗逆转录病毒治疗(HAART),并严格执行术前消毒,术中无菌操作、术后观察及换药,可有效防止AIDS合并白内障患者术后感染的发生。

Effect of surgical infection control during perioperative period in patients with acquired immunodeficiency syndrome complicated with cataract after systemic highly effective antiretroviral therapy

ObjectiveTo investigate the effect of surgical infection control during perioperative period after systemic highly effective antiretroviral therapy (HAART) in patients with acquired immunodeficiency syndrome (AIDS) complicated with cataract. MethodsThe basic data of 10 patients with AIDS complicated with cataract before and after operation collected from Beijing Ditan Hospital, Capital Medical University were analyzed, retrospectively. ResultsAfter systemic highly effective antiretroviral therapy (HAART) for 10 cases with AIDS and cataract, the CD4⁺ T lymphocyte count increased to 196-745 cells/μl, witout complications. Eight patients received cataract phacoemulsification combined with intraocular lens implantation. One patient was complicated with macular membrane, and the other one was complicated with retinal detachment. Both the two cases were treated with vitrectomy combined with phacoemulsification and intraocular lens implantation. No infection occurred in all 10 patients with AIDS complicated with cataract. ConclusionsHAART for AIDS patients with cataract before surgery, strict preoperative disinfection, intraoperative aseptic operation, postoperative observation and dressing change could effectively prevent the occurrence of postoperative infection in AIDS patients complicated with cataract.