不同消毒时机预防内眼术后眼内感染的临床对比研究

Clinical Comparative Study of Different Timings of Preventive Disinfection of Postoperative Endoph-thalmitis

doi:
10.3969/j.issn.1006-2084.2015.04.069
摘要:
目的:比较不同消毒时机预防内眼术后眼内感染的效果。方法选择红河州第一人民医院2012年6月至2013年6月收治的168例白内障手术患者作为研究对象,按照随机数字表法分为术前一次聚维酮碘消毒组、术前二次聚维酮碘消毒组、术前术后聚维酮碘消毒组,每组56例。术前一次聚维酮碘消毒组用生理盐水结膜囊冲洗,聚维酮碘消毒后再次生理盐水冲洗;术前二次聚维酮碘消毒组患者在聚维酮碘消毒组消毒基础上术前再次聚维酮碘消毒后手术;术前术后聚维酮碘消毒组患者术前消毒方法同聚维酮碘消毒组,术后聚维酮碘消毒后直接包扎伤口。对3组患者消毒前后结膜囊标本进行病原菌培养,对病原菌数量及分布进行比较。结果消毒前,聚维酮碘消毒组培养出21株病原菌,占37.5%(21/56);术前二次聚维酮碘消毒组培养出22株病原菌,占39.3%(22/56);术前术后聚维酮碘消毒组培养出20株病原菌,占35.7%(20/56);3组消毒前病原菌比较差异无统计学意义(P >0.05)。术后,3组病原菌培养阳性数均明显降低,术前一次聚维酮碘消毒组、术前二次聚维酮碘消毒组、术前术后聚维酮碘消毒组阳性率分别为10.7%、8.9%、7.1%,3组比较差异无统计学意义(P >0.05)。术前一次聚维酮碘消毒组无明显不良反应病例,术前二次聚维酮碘消毒组、术前术后聚维酮碘消毒组各有1例眼部有明显刺激感,发生率为1.8%,3组不良反应发生率比较差异无统计学意义(P >0.05)。结论术前聚维酮碘消毒后生理盐水冲洗既可达到内眼手术无菌的要求,又可减少对眼部的刺激、缩短手术时间。
Abstract:
Objective To study the effect of different disinfection opportunities to prevent the postopera-tive intraocular eye infection.Methods A total of 168 cataract surgery patients admitted to the First People′s Hospital of Honghe Prefecture from Jun.2012 to Jun.2013 were included in the study,according to random-number table method they were divided into preoperative povidone-iodine disinfection group, preopeartive two-time povidone iodine disinfection group, preoperative and postoperative povidone-iodine disinfection group,56 cases in each group.One standard disinfection was rinsing the conjunctival sac with physiological saline then povidone-iodine and saline rinse again.The preoperative two-time infection group was given one more povidone-iodine after saline rinse.The samples from the conjunctival sac of the three groups were culti-vated for pathogens,and the quantity and distribution of the pathogens were compared.Results Before dis-infection culture of pathogens in the three groups were 21 pathogens ( 21 /56, 37.5%); 22 pathogens (22 /56, 39.3%);and 20 pathogens(20 /56,35.7%) respectively,which had no statistically significant difference(P >0.05).After disinfection the positive rate of the three groups were 10.7%,8.9%,7.1%respectively,which had no statistically significant difference(P >0.05).There was no obvious adverse reac-tion in the preoperative povidone-iodine disinfection group,while there was one of obvious irritation in each of the rest two groups,the incidence was 1.8%,and there was no significant difference between the three groups (P >0.05 ).Conclusion Preoperative disinfection with povidone-iodine and physiological saline can achieve the sterile requirement,with reduced eye irritation and shortened operation time.
作者 崔金鹏    张弘    吕含韬
Author: CUI Jin-peng    ZHANG Hong    LV Han-tao
作者单位 红河州第一人民医院五官科,云南 蒙自,661199
刊 名: 医学综述   ISTIC
Journal: Medical Recapitulate
年,卷(期) 2015, (4)
分类号 R779.66
关键词: 内眼手术 知识脉络    眼内感染 知识脉络    消毒时机 知识脉络    预防 知识脉络   
Keywords: Intraocular surgery    Endophthalmitis    Disinfection opportunity    Prevention   
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