不同蒸汽灭菌方法对白内障超声乳化术后炎性反应的影响

Different sterilization methods about effect of inflammatory response for the operation eyes after phacoemulsification

目的比较高压蒸汽灭菌和快速压力蒸汽灭菌对白内障超声乳化术后患者术眼炎性反应的差异，探讨不同蒸汽灭菌方法的效果，为合理选择超声乳化手术器械的灭菌方式提供依据。方法对在暨南大学附属第一医院眼科行白内障超声乳化手术的51例患者60只眼，按随机化原则分为高压蒸汽灭菌组25例30只眼和快速压力蒸汽灭菌组26例30只眼，分别于术后1d、3d、7d观察两组患者术眼的视力、结膜反应、角膜反应、前房反应、眼压、角膜内皮细胞密度、人工晶状体位置以及病人舒适度。结果两组患者术后1d、3d、7d的视力、角膜内皮细胞密度、眼压、结膜反应、角膜反应、前房反应差异均无统计学意义（P〉O．05）。人工晶状体位置正、病人无不适。且两组灭菌后的器械细菌培养结果均为阴性。结论快速压力蒸汽灭菌法对于白内障超声乳化手术具有与高压蒸汽灭菌法一样的手术效果，没有明显增加其术后炎性反应，是超声乳化手术器械安全可靠、快速高效的灭菌方法。

Objective To compare the differences of inflammatory response on the operation eyes after phacoemulsification between autoclave sterilization and flash sterilization, and to explore their effect and provide evidences for reasonable sterilization methods selection of the phacoemulsification instruments. Methods Sity eyes in 51 patients which received phacoemulsification in Department of Ophthalmology in First Affiliated Hospital of Jinan University were divided into two groups randomly. One was the autoclave sterilization group with 30 eyes in 25 patients, and the other was flash sterilization group with 30 eyes in 26 patients. Visual acuity, conjunctiva, cornea, anterior chamber reaction, intraocular pressure, corneal endothelial cell density, intraocular lens position and patient comfort were observed in the 1st, 3rd, 7th day after operation. Results Two groups had no significant difference （P 〉0.05） in visual acuity, corneal endothelial cell density, intraocular pressure, corneal conjunctival reaction, anterior chamber reaction in the 1st, 3rd, 7th day after operation. The intraocular lens was in normal position. The patient had no discomfort. Conclusions The flash sterilization has the same operative results as autoclave sterilization in phacoemulsification and the inflamma- tory response of the operation eyes after phacoemulsification has no obvious increase. The flash sterilization is a safe, reliable and eff^cient sterilization method of the instruments of phacoemulsification.