不同浓度安尔碘冲洗液术前结膜囊冲洗的效果

Effects of povidone-iodine solution with different concentration on the conjunctival sac washing before intraocular operation

目的：探讨不同浓度安尔碘冲洗液术前结膜囊冲洗消毒的效果。方法选择拟行内眼手术患者150例，按照随机数字表法随机分为0．01％安尔碘组、0．025％安尔碘组、0．05％安尔碘组，每组各50例。3组患者术前均行常规的内眼手术准备，进入手术室后均用0．5％的碘伏消毒术眼皮肤和睑缘，手术开始前3组患者分别用相应浓度的安尔碘冲洗液进行结膜囊冲洗，冲洗后1 min做结膜囊细菌培养，之后使用荧光素钠进行角膜染色，裂隙灯下观察结膜充血状态和角膜上皮损伤情况，比较3组效果。结果0．025％和0．05％的安尔碘冲洗液冲洗后细菌培养阴性率分别为92．0％，94．0％，优于0．01％安尔碘冲洗液78．0％，差异有统计学意义（χ2＝7．197，P＜0．05）；0．05％安尔碘冲洗液对结膜的刺激性和对角膜上皮的损伤大于其他两组（χ2值分别为20．257，18．656；P＜0．05）。结论0．025％安尔碘冲洗液有高效的杀菌作用，且对眼部角、结膜无破坏性损伤，故更适于眼科手术术前结膜囊消毒。

Objective To investigate the effect of different concentration of povidone-iodine solution on preoperative irrigation of the conjunctival sac .Methods A total of 150 patients were randomly divided into Group A, B and C, each group had 50 cases.All patients were performed with conventional intraocular surgery＇s preparation.First, 0.5%iodine solution was used to disinfect all patients＇eyelid, surrounding skin and limbi palpebralis after entering operation room .Second, irrigation of the conjunctival sac was performed （ three different concentration separately ） before operation.1 minute later, bacterial culture of conjunctiva sac and immediately corneal fluorescein staining was done .The degree of conjunctival hyperemia and corneal epithelial damage under slit lamp were compared among groups .Results The negative rate of bacterial culture of conjunctiva sac of the groups using 0.025% iodine solution and 0.05% iodine solution were 92.0% and 94.0%.The effects were better than 78.0%of 0.01%iodine solution group.There were significant differences between groups （χ2 =7.197,P〈0.05）.0.05% iodine solution had a more serious effects and worse corneal epithelial damage compared with the other groups .There were significant differences between groups （χ2 =20.257,18.656, respectively;P〈0.05）.Conclusions 0.025% iodine solution has better bactericidal effect and higher efficiency , and has little damage to the cornea and conjunctiva , so it is more suitable to preoperative disinfection of conjunctival sac in operation in ophthalmology .