应用抗菌药物降低结膜囊细菌量的临床研究

Application of antimicrobial agents for reducing conjunctival sac bacterial flora

目的探讨局部和全身应用抗菌药物对降低结膜囊细菌量的效果。方法随机抽取白内障患者82例(164眼)作为研究对象,同一患者的未手术眼为研究对照眼。术前3 d,手术眼用0.5%左氧氟沙星滴眼液点眼;术前30 min,患者全身应用抗菌药物。在以下时间采集双眼结膜囊标本,行细菌培养:入院时(T0);手术眼应用0.5%左氧氟沙星滴眼液3 d后(T1);患者全身应用抗菌药物30 min后(T2)。结果手术眼和对照眼T0、T1、T2结膜囊细菌培养阳性率分别为42.68%(35/82)、0(0/82)、0(0/82)和43.90%(36/82)、8.54%(7/82)、0(0/82)。结论局部或全身应用抗菌药物均可降低结膜囊细菌量。由于全身应用抗菌药物副作用大,不建议在常规白内障手术前应用。

Objective To evaluate the efficacy of topical and systemic antimicrobial application on reducing con- junctival sac bacterial flora. Methods 82 cataract patients （164 eyes） were randomly selected for studying, non- surgical eye of the same patient was as control eye. Surgical eyes received 3-day preoperative 0.5 % levofloxacin eye drops, all patients received systemic antimicrobial agents 30 minutes before surgery. Specimens from conjunctival sac were collected at the following time points：admission （TO） ; 3 days after receiving 0.5% levofloxacin eye drops before surgery （T1）; 30 minutes after all patients received systemic antimicrobial agents （T2）, all specimens were performed bacterial culture. Results The percentage of positive cultures for surgical and control eyes was 42.68% （35/82） and 43.90% （36/82） at TO, 0 （0/82）and 8.54%（7/82）at T1, 0（0/82） and 0 （0/82）at T2,respectively. Conclusion Topical and systemic antimicrobial application can reduce conjunctival sac bacteria. Because of the side effects of systemic antimicrobial agents, preoperative routine systemic antimicrobial use is not suggested.