眼外伤围手术期左氧氟沙星不同给药途径预防感染的临床观察

Clinical Observation on Different Administrations of Levofloxacin to Eyes Traumas during Perioperative Period for Preventing Infection

[目的]探讨左氧氟沙星滴眼及口服在眼外伤围手术期预防感染的临床效果。[方法]将126例非开放性眼外伤患者随机分为A组(左氧氟沙星滴眼液预防感染组)66例,B组(左氧氟沙星注射静脉用药预防感染组)60例,将162例开放性眼外伤患者随机分为C组(左氧氟沙星滴眼液加口服左氧氟沙星预防感染组)80例,D组(左氧氟沙星注射液静脉用药预防感染组)82例,分别比较A、B两组及C、D两组患者使用左氧氟沙星前和术后细菌培养阳性率。[结果]A、B两组及C、D两组使用左氧氟沙星前后阳性率比较,差异有统计学意义(P<0.05);两组术后阳性率的差异无明显统计学意义(P>0.05)。不良反应:单纯使用局部滴眼预防感染的A组显著低于B组(P<0.01);口服加局部使用药物的C组显著低于D组(P<0.01)。[结论]眼外伤围手术期左氧氟沙星口服和滴眼预防感染与静脉滴注预防感染临床效果相同,而局部用药可减少抗生素用量,减少全身用药,不良反应少,亦能有效预防眼外伤术后感染,值得临床推广和应用。

[Objective] To discuss the clinical effect of Levofloxacin in eye drop and oral taking on preventing infection for eyes traumas during perioperative period. [Method] Respectively select 126 cases of non-open eye trauma operation and 162 cases of open eye trauma operation, divide the non-open eye trauma patients into group A（Levofloxacin eye drop） 66 cases and group B（Levofloxacin injection in vein drop） 60 cases, compare both bacteria culture positive rates before administration and after operation;divide the open eye trauma patients into group C（Levofloxacin in eye drop and oral taking）80 cases and group D（Levofloxacin in vein drop） 82 cases, compare both positive rates of bacteria culture before and after the administration and operation.[Result] Comparing group A and group B with groups C and D, the positive rate before and after Levofloxacin administration, there ’s difference of statistical meaning, but without marked statistical meaning after operation. Side effects： the positive rate of bacteria culture was 56.25% before administration, and 10.13% after operation; for group D, they were 59.80% and 12.20% respectively, the difference had statistical meaning on Levofloxacin, but without difference of statistical meaning on positive rate. Purely using focal eye drop had no side effects on group A; the side effects of oral taking and focal administration on group C were much lower than groups B and D. [Conclusion] For eye trauma in perioperative period, the oral taking and eye drop of Levofloxacin have the same effects on infection prevention compared as vein drop, while the focal administration can reduce antibiotics usage and systemic administration, with little side effects, as wel as effectively prevent post-operation infection of eye trauma, worth clinical promotion and application.