两种结膜囊冲洗液消毒效果与白内障手术患者眼部感染状况研究

A STUDY OF STERILIZING EFFECTS WITH TWO TYPES OF CONJUNCTIVAL DISINFECTION FLUID IN CATARACT SURGERY OF EYE INFECTION

目的探讨5%Ⅲ型安尔碘皮肤粘膜消毒剂稀释液对白内障手术患者术前结膜囊的消毒效果。方法使用随机对照双盲临床试验的方法,将205例(205眼)白内障患者随机分为A组(104例)和B组(101例),A组手术前30 min,用0.5%爱尔凯因表面麻醉剂点眼1次,5 min后用5%Ⅲ型安尔碘稀释液20 ml加生理盐水60～100 ml冲洗结膜囊,手术开始前10 min用0.5%爱尔凯因表面麻醉剂点眼2次,B组手术前30 min,用0.016%庆大霉素冲洗液冲洗结膜囊,手术开始前15 min用0.5%爱尔凯因表面麻醉剂点眼3次,其它处理相同。手术当日在清洗处理前、清洗消毒处理后、手术开始前对结膜囊的普通细菌培养。结果洗眼前A组细菌培养阳性率为17.34%,B组细菌培养阳性率为13.86%,经统计两组之间无显著性差异(p>0.05);洗眼后A组细菌培养阳性率为5.76%,经2检验与洗眼前差异有显著意义(p<0.01);B组细菌培养阳性率为5.94%,经2检验与洗眼前差异无显著意义(p>0.05)。结论 5%Ⅲ型安尔碘皮肤粘膜消毒剂稀释液用于白内障术前结膜囊消毒是一种安全、有效的术前结膜囊消毒方法。

Objective To explore the sterilizing effects of 5% Anerdian type 3 disinfectant dilution for conjunctival sac disinfection in cataract surgery. Methods Using randomized controlled trial method, 205 cataract patients （205 eyes）were allocated into two groups： group A, in which anerdian was applied for eonjunctival sac disinfection, and group B in which 0. 016% gentamycin were adopted for conjunctival sac disinfection. Patients in both groups were using fluoroquinolone eye drops qid for 3 days preoperatively, For group A, use 0. 5% Aleaine eye drops for topical anaesthesia, 5 rain later use 5% Anerdian type 3 disinfectant dilution 20 ml plus 60 - 100 ml normal saline for conjunctival sac disinfection, 10 min before operation use 0. 5% Alcaine eye drops for topical anaesthesia twice; for group B, 30 min before operation use 0. 016% gentamycin dilution for conjunctival sac irrigation, 15 min before operation use 0. 5% Alcaine eye drops for topical anaesthesia 3 times, the others are similar to group A. Conjunctival specimens were obtained for bacterial culture and analysis from operative eye before and after conjunctival disinfection. Results The positive bacterial culture rate of group A before conjunctival sac disinfection was 17. 34%. That of the group B was 13.86%. There was no statistically significant difference between the two groups （p 〉 0. 05 ）. The positive bacterial culture rate of group A after conjunctival sac disinfection was 5.76%. The difference between pre - and post -conjunctival sac disinfection was statistically significant by Chi -square test（p 〈 0. 01 ）. The positive bacterial culture rate of group B after conjunctival sac disinfection was 5.94%. There was no statistically significant difference between pre - and post -conjunctival sac disinfection by Chi -square test（p 〉 0. 05 ） ;The positive bacterial culture rate of group A before operation disinfection by using 5% Anerdian type 3 disinfectant dilution was 4. 80%. That of the group B was 1.98%. There was no statistically significant difference between the two groups（p 〉 0. 05 ）. Conclusion 5% Anerdian type 3 disinfectant dilution for conjunctival sac disinfection before cataract surgery is a safe and effective method.