盐酸去甲万古霉素结膜下注射的眼表安全性评估

Ocular surface safety assessment of subconjunctival injecting Norvancomycin Hydrochloride

目的评估内眼手术后结膜下注射盐酸去甲万古霉素的眼表安全性。方法采用前瞻性非随机对照临床试验,将64例(均为单眼)内眼手术后患者分为A、B 2组,A组结膜下注射10 mg去甲万古霉素(n=33),B组结膜下注射20 mg去甲万古霉素(n=31),比较观察2组术后第1天及术后1周的眼表情况。结果术后第1天,2组均出现结膜水肿及结膜下出血。结膜水肿高度分级:A组1级24例,2级8例,3级1例;B组1级14例,2级13例,3级4例,A组好于B组(P<0.05)。结膜水肿面积:A组(74.58±20.050)mm2,B组(89.42±16.998)mm2(P<0.05)。结膜下出血面积:A组(75.97±16.423)mm2,B组(87.32±13.828)mm2(P<0.05)。B组有15例结膜下残留药物颗粒。术后1周,2组结膜水肿消失,结膜下出血明显减轻,B组结膜下颗粒状药物完全吸收,未见角膜水肿、混浊,结膜坏死及结膜瘢痕。结论去甲万古霉素用于结膜下注射是安全的,10mg剂量的眼表安全性更高。

OBJECTIVE To assess the ocular surface safety of subeonjunetival injecting Norvaneomyein Hydrochloride after intraocular surgery. METHODS A prospective non-random clinical study was performed in 64 cases （oeellanae）,who received intraocular surgery in our hospital. Patients were divided into group A and B. Group A was subconjunctival injected 10mg Norvancomyein （n=33）, group B was injected 20 mg （n=31 ）.The ocular surface of two groups were observed in the first day and one week after intraoeular surgery. RESULTS Two groups occurred subconjunctival edema and subconjunctival hemorrhage in the first day .The height of subconjunctival edema was divided into 3 levels：in group A, level 1 was 24 cases,level 2 was 8 cases,level 3 was 1 case;in group B,level 1 was 14 cases ,level 2 was 13 cases ,level 3 was 4 cases. Group A was slighter than B in the degree of subeonjunetival edema（P〈0.05）. The area of subeonjunetival edema was （74.58±20.050）mm2 and （89.42±16.998）mm2 respectively in group A and B（P〈0.05）. The area of subeonjunetival hemorrhage was （75.97±16.423）mm2 and（87.32±13.828） mm2 respectively in group A and B （P〈0.05）. Group B appeared 15 cases subconjunetival medicine residue. The subeonjunetival edema of two groups was vanished and subeonjunetival hemorrhage was conspicuous lessened after one week, moreover, subconjunetival medicine residue was completely absorbed in group B. There was no corneal edema and opacity,eonjunctiva necrosis and eonjunctival scar in the two groups. CONCLUSIONS The ocular surface of subeonjunetival injecting Norvaneomyein Hydrochloride was safe and the safety was better when injected 10mg Norvancomyein.