内眼手术前有效预防感染措施的研究

发布时间：2018-05-23 12:04

本文选题：结膜囊细菌培养 + 内眼手术　；参考：《延边大学》2010年硕士论文

【摘要】： 目的：通过比较单纯抗生素滴眼液滴眼、联合结膜囊冲洗和再联合术前全身应用广谱抗生素等三种措施后的结膜囊无菌化效果,探讨内眼手术前全身预防性应用抗生素的必要性。方法：随机选择200眼分为对照组(50眼)及实验组(150眼)。实验组随机分为Ⅰ、Ⅱ、Ⅲ组,每组50眼。四组均在尚未干预结膜囊之前进行结膜囊细菌培养。其中对照组应用生理盐水100ml冲洗；对第Ⅰ组50眼滴左氧氟沙星滴眼液,每天4次、连续滴3天后作结膜囊细菌培养；对第Ⅱ组50眼滴左氧氟沙星滴眼液并用生理盐水100毫升冲洗结膜囊后作结膜囊细菌培养；对第Ⅲ组50眼滴3天左氧氟沙星滴眼液、静脉点滴左氧氟沙星注射液100ml后1h时再用生理盐水100毫升冲洗结膜囊后作结膜囊细菌培养。结果：1.Ⅰ组50眼左氧氟沙星滴眼液滴眼前后结膜囊细菌培养阳性率分别为34.0%和12.0%,前后细菌培养阳性率差异有统计学意义(x2=6.832,P0.01)。2.第Ⅱ组50眼滴左氧氟沙星滴眼液3天并用生理盐水100毫升冲洗结膜囊前后结膜囊细菌培养阳性率分别为38.0%和8.0%,前后细菌培养阳性率差异有统计学意义(x2=12.705,P0.01)。3.对第Ⅲ组50眼滴左氧氟沙星滴眼液、静脉点滴左氧氟沙星注射液100ml后1h时再用生理盐水100毫升冲洗结膜囊前后结膜囊细菌培养阳性率分别为36.0%和4.0%。采用三种联合措施前后细菌培养阳性率差异有统计学意义(x2=16.000,P0.01)。4.Ⅰ、Ⅱ、Ⅲ组尚未干预结膜囊之前结膜囊细菌培养阳性率分别为34.0%、38.0%和36.0%,三组间差异无统计学意义(x2=0.174,P0.05);而Ⅰ、Ⅱ、Ⅲ组采取三种不同结膜囊无菌化措施后结膜囊细菌培养阳性率分别为12.0%、8.0%和4.0%,Ⅰ组和Ⅱ组、Ⅱ组和Ⅲ组间差异有统计学意义(x2=10.606,P0.01)。结论：1.内眼术前使用左氧氟沙星和生理盐水冲洗结膜囊,是内眼手术前预防眼内感染的有效措施,可常规实施。2.术前1h静脉使用左氧氟沙星注射液可明显提高结膜囊细菌清除率,有助于预防内眼手术后眼内感染。
[Abstract]:Objective: To explore the aseptic effect of the conjunctival sac after three measures such as simple antibiotic drop eye drops, combined conjunctival sac flushing and reunion of broad spectrum antibiotics before operation, and to explore the necessity of systemic antibiotic application before operation.
Methods: randomly selected 200 eyes were divided into control group (50 eyes) and experimental group (150 eyes). The experimental group was randomly divided into group I, group II, group III and 50 eyes in each group. The four groups were cultured in conjunctival sac before the conjunctival sac was not intervened. The control group was washed with saline 100ml, and 50 eyes drop left Ofloxacin Eye Drops, 4 times a day, 3 in group I. The bacterial culture of conjunctival sac was made in the second group; 50 eyes drop left Ofloxacin Eye Drops and 100 ml of normal saline were used to develop conjunctival sac for bacterial culture. 3 days of 3 days left Ofloxacin Eye Drops in group 50, and after intravenous drip of Levofloxacin Injection 100ml after intravenous drip of 100 ml of normal saline, after the conjunctival sac was used as a knot. Culture of membrane capsule bacteria.
Results: the positive rate of bacterial culture of conjunctival sac before and after 1. eyes of 50 eyes in group 1. I was 34% and 12% respectively. The positive rate of the positive rate of bacterial culture before and after was statistically significant (x2=6.832, P0.01).2., group II, 50, 50 eyes, left Ofloxacin Eye Drops, 3 days and the culture of conjunctival sac before and after the conjunctival sac of 100 ml of physiological saline The rate of sex was 38% and 8% respectively. The positive rate of the positive rate of bacteria culture before and after was statistically significant (x2=12.705, P0.01).3. to group III, 50 eyes drop left Ofloxacin Eye Drops, intravenous drip of Levofloxacin Injection 100ml after 1h and 100 ml of physiological saline rinse conjunctival sac before and after the conjunctival sac bacteria culture positive rate was 36% and 4.0%. adopted, respectively. There was significant difference in the positive rate of bacterial culture before and after the three measures (x2=16.000, P0.01).4. I, II, group II, group III before the conjunctival sac bacteria culture positive rates were 34%, 38% and 36%, respectively, there was no statistical difference between the three groups (x2=0.174, P0.05); and I, II, III group adopted three different conjunctival sac aseptic measures The positive rates of bacterial culture in posterior conjunctival sac were 12%, 8% and 4%, respectively. There was significant difference between group II and group II, group II and group III (x2=10.606, P0.01).
Conclusion: 1. the treatment of conjunctival sac by using levofloxacin and saline before internal ophthalmic operation is an effective measure to prevent intraocular infection before internal ocular surgery. The routine implementation of 1H intravenous Levofloxacin Injection before.2. can obviously improve the bacterial clearance rate of conjunctival sac and help prevent intraocular infection after internal eye operation.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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