老年糖尿病患者白内障围手术期感染的病原学分析及抗菌药物应用

发布时间：2018-04-22 10:15

本文选题：老年患者 + 糖尿病　；参考：《中华医院感染学杂志》2014年06期

【摘要】：目的分析老年糖尿病患者白内障围手术期感染的病原菌构成及特点,对抗菌药物的应用及效果进行探讨,以期为提高临床对老年糖尿病白内障患者围手术期感染诊治水平提供参考。方法回顾性分析医院2009年1月-2013年1月69例糖尿病患者白内障围手术期感染临床资料,分析患者围手术期抗菌药物的应用情况;采用SPSS13.0软件进行统计分析。结果 69例患者术前结膜囊细菌培养阳性54例、术后切口感染13例、眼内感染2例;病原菌培养主要为革兰阳性菌,其中以表皮葡萄球菌为主,共41株占59.42%,革兰阴性菌以铜绿假单胞菌为主,共5株占6.33%,培养出真菌3株,均为白色假丝酵母菌,占4.35%;具有抗菌药物适应证的患者仅11例,无适应证用药的58例占84.06%;术前给药时间合理的30例占43.48%;100.00%的患者术后用药时间24h,66例患者为全身性用药,占95.65%,以上指标均具有代表性(P0.05);全身静脉用药以头孢呋辛钠为主,37例占30.58%;另有少数患者使用头孢唑林和左氧氟沙星,局部滴眼或球结膜下注射药物分别是庆大霉素注射液、妥布霉素/地塞米松滴眼液、左氧氟沙星滴眼液、氯霉素滴眼液。结论高龄与糖尿病均是感染发生的高危因素,合理使用抗菌药物,加强手术的无菌控制及围手术期的血糖控制是降低感染的有效手段。
[Abstract]:Objective to analyze the pathogenic bacteria composition and characteristics of perioperative cataract infection in senile diabetic patients, and to discuss the application and effect of antimicrobial agents. In order to improve the clinical diagnosis and treatment of diabetic cataract patients perioperative level of reference. Methods the clinical data of 69 diabetic patients with cataract infection during perioperative period from January 2009 to January 2013 were retrospectively analyzed and the application of antimicrobial agents in perioperative period was analyzed by SPSS13.0 software. Results the bacterial culture of conjunctival sac was positive in 54 cases before operation, 13 cases with incision infection and 2 cases with intraocular infection. A total of 41 strains accounted for 59.42, and gram-negative bacteria were mainly Pseudomonas aeruginosa, 5 strains were 6.33, and 3 strains were Candida albicans, all of which were Candida albicans (4.35%). There were 58 cases (84.06%) without indications and 30 cases (43.48%) with reasonable preoperative administration time. 66 cases (24 hours after operation) were treated with systemic drugs. The above indexes were all representative P0.05A, 37 patients were treated with cefuroxime sodium, and a few patients were treated with cefazolin and levofloxacin, and gentamicin injection was used locally or subconjunctival injection. Tobramycin / dexamethasone eye drops, levofloxacin eye drops, chloramphenicol eye drops. Conclusion both old age and diabetes mellitus are high risk factors for infection. Rational use of antimicrobial agents, strengthening of aseptic control during operation and control of blood sugar in perioperative period are effective measures to reduce infection.
【作者单位】：浙江省安吉县中医医院眼科;浙江省安吉县中医医院检验科;
【基金】：吉安县科技局专项基金项目(ZJ-2008B-042)
【分类号】：R587.1;R779.66

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