摘要
目的探讨糖尿病并发性白内障患者手术前后结膜囊细菌菌群变化,为预防术后眼内炎发生提供依据。方法选取2013年1月-2014年12月眼科行白内障超声乳化摘除及人工晶体植入术的178例糖尿病患者的178眼为研究对象,随机分为A组和B组,各89例;A组患者术前3d用左氧氟沙星眼液点患眼每日4次,B组患者术前1d用左氧氟沙星眼液滴眼每小时1次,术前均采用0.5%聚维酮碘结膜囊消毒,分别于用药前、术前、术后采集结膜囊标本进行细菌培养,分析结膜囊菌群变化。结果两组患者术后均无眼内炎发生,手术前A、B组结膜囊阳性率与用药前比较显著降低(χ2=28.0378、15.2391,P<0.05),手术后A、B组阳性率与手术前比较显著降低(χ2=4.7264、10.1568,P<0.05);手术前A组阳性率与B组比较差异有统计学意义(P<0.05),用药前与手术后A组阳性率与B组比较差异无统计学意义;A、B组患者用药前、手术前、手术后以革兰阳性菌为主,用药后、手术后细菌菌群数量降低;年龄>70岁、糖尿病病程>5年、合并糖尿病视网膜病变的患者结膜囊细菌培养阳性率较高(P<0.05)。结论糖尿病并发性白内障患者结膜囊带菌量多,术前应用抗菌药物滴眼可减少结膜囊含菌量。
OBJECTIVE To explore the changes of conjunctival bacterial flora in patients with diabetes mellitus before and after cataract surgery,in order to provide evidence for preventing the occurrence of postoperative intraocular inflammation.METHODS A total of 178 eyes of 178 patients with diabetes mellitus in the hospital from Jan.2013 to Dec.2014 were collected and treated with phacoemulsification and intraocular lens implantation.The patients were randomly divided into group A and group B,89 cases in each group.Patients in group A were given levofloxacin eye drops 4times/day three days before surgery,patients in group B were given levofloxacin eye drops 1time/hour one day before surgery.0.5% povidone-iodine was used for disinfection of conjunctival sac before surgery.Conjunctival specimens were collected for bacterial culture before treatment,preoperatively and postoperatively to analyze changes of conjunctival flora.RESULTS There was no endophthalmitis in patients of both groups after surgery.The conjunctival positive rate in group A and group B before surgery was significantly lower than before medication（χ^2= 28.0378,15.2391,P〈0.05）.Before surgery,the positive rate between group A and group B had significant difference（P〈0.05）.Before medication and after surgery,the positive rate between group A and group B had no significant difference.Gram-positive strains were the dominant bacteria in both groups before medication,before surgery and after surgery.The number of bacterial flora was reduced after medication and after surgery.The positive rate of conjunctival bacterial culture was higher in patients with age 〉70 years,diabetes duration 〉5years and complication with diabetic retinopathy（P〈0.05）.CONCLUSION The results show that the amount of conjunctival bacteria is high in diabetic patients complicated with cataract,preoperative antibiotic eye drops can reduce bacterial amount in conjunctival sac.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第5期1064-1066,共3页
Chinese Journal of Nosocomiology
基金
重庆市卫计委科研基金资助项目(2015HBRC011)
关键词
糖尿病
结膜囊
病原菌
眼内炎
Diabetes
Conjunctival sac
Pathogen
Endophthalmitis
