强化妥布霉素滴眼液在外因性细菌性眼内炎治疗中的应用

Effect of high concentration of to-bramycin eyedrop on treatment of bacterial endophthalmitis

目的:探讨强化妥布霉素滴眼液治疗急性外因性细菌性眼内炎的方法和疗效。方法:54例随机分成两组,每组27例(27眼)。强化治疗组(A组):13.4g/L妥布霉素滴眼液滴眼;对照组(B组)3g/L妥布霉素滴眼液滴眼。两组均进行前房冲洗加前房注射万古霉素,辅以全身加局部同种和相同剂量的抗生素及激素治疗。分别观察两组房水渗出全部吸收平均时间、角膜水肿完全消退平均时间、房水病原菌培养结果和术后1mo最佳矫正视力,统计学处理采用t检验。结果:两组病例眼内炎症均得到控制,大部分视力得到不同程度改善。强化治疗组房水纤维素性渗出吸收时间短于对照组,统计学分析有显著性差异。两组房水病原菌培养结果和术后1mo最佳矫正视力分布差异没有统计学意义。结论:对于急性外因性细菌性眼内炎,在及时前房冲洗、前房注药治疗或者联合玻璃体切割术之外,13.4g/L强化妥布霉素滴眼液频繁滴眼有利于眼内炎症控制,是有效而且安全的辅助治疗方法。

AIM： To evaluate the effect of 13.4g/L tobramycin eyedrop on the treatment of bacterial endophthalmitis. METHODS： Fifty-four patients （54 eyes） were randomly divided into 2 groups： 13.4g/L tobramycin eyedrop （group1, 27 eyes） and 3g/L tobramycin eyedrop （group 2, 27 eyes）. All the 54 cases received anterior chamber （AC） irrigation with vancomycin AC injection, combined sys- temic and topical antibiotic/corticosteroid administration. The mean period of the absorption of the exudation in AC, the elimination of the corneal edema, the results of pathogenic bacteria culture, and the best corrected vision at postoperative 1mo were observed, t-test was used for statistical analysis. RESULTS： All the 54 eyes were saved from endophthalmitis, with visual improvement in most cases. The inflammatory exudation in AC aqueous was absorbed faster in group 1 than that in group 2 （P〈0.05）. There were no statistical differences in the results of pathogenic bacteria culture and best corrected vision. CONCLUSION： The 13.4g/L tobramycin eyedrop is one of the effective and safe topical antibiotic administrations in the treatment of bacterial endophthalmitis.