前房注射头孢呋辛对术后眼内炎的预防作用(英文)

Prophylactic usage of intracameral cefuroxime in the prevention of postoperative endophthalmitis

目的:研究前房注射头孢呋辛对术后眼内炎的预防作用。方法:回顾性研究6 099例行超声乳化白内障手术的年龄相关性白内障患者。对照组,2001-10/2004-05,3 075例3 075眼行白内障手术未用眼内抗生素,实验组,2004-06/2007-04,3 024例3 024眼术中前房用0.1mL含1mg的头孢呋辛。两组的术前预防措施和手术步骤相同。结果:对照组和实验组分别有13(0.42%)和4(0.13%)例患者发生术后眼内炎[P=0.031;OR =3.20(1.04-9.84)]。两组发生术后眼内炎的平均时间分别是术后30(3 ～75)d和25(2 ～35)d(P=0.35)。研究细菌感染,实验组,烟曲菌和铜绿假单胞菌对头孢呋辛耐药,而肺炎链球菌对头孢呋辛敏感。未发现前房运用头孢呋辛的毒性和过敏性症状。结论:预防性前房运用头孢呋辛是安全的,可以预防术后细菌性眼内炎。然而抗生素抗菌谱窄和抗生素耐药性的可能性需要考虑。

AIM. To evaluate the prophylactic usage of intracameral cefuroxime in the prevention of postoperative endophthalmitis （PE）. METHODS： Phacoemulsification surgery of 6 099 patients with age-related cataract was studied retrospectively. In control group, 3 075 patients （3 075 eyes） had undergone surgery without use of intraocular antibiotics （IOA） between October 2001 and May 2004; and in study group 3 024 patients （3 024 eyes） had undergone the surgery with intracameral cefuroxime 1 mg in 0. I mL between June 2004 and April 2007. Peroperative prophylaxis and operative procedures were the same in both groups. RESULTS： PE developed in 13 （0.42%） and 4 （0.13%） patients in the control and the study groups respectively E P = 0. 031 ; odds ratio = 3.20 （1.04-9.84） 1. PE developed 30 （3-75） days, and 25 （2-35） days after the surgeries in the two groups （ P = 0.35） respectively. Monomicrobial infections were observed. In the study group Aspergillus fumigatus and Pseudomonas aeruginosa were resistant to cefuroxime; however, Streptococcus pneumonia was sensitive to cefuroxime. No sign of toxicity or allergy from intracameral cefuroxime was noted. CONCLUSION： Intracameral prophylactic cefuroxime appears safe. It may provide considerable protection against bacterial PE; however, possibility of insufficient antibiotic coverage and antibiotic resistance of causative microorganism should be considered.