高分子义眼材料表面菌斑生物膜的清洁效应

The cleaning of plaque biofilm on the surface of macromolecule ocular prosthesis material

背景:义眼戴入后结膜囊内的微生态环境被打破,其自洁作用减弱,更利于微生物的生长和定植,义眼表面菌斑生物膜的清洁效果影响佩戴舒适度和患者生活质量,寻求一种有效的清洁方法有其必要性。目的:比较5种清洗方法对义眼表面菌斑生物膜的清洁效果。方法:对84例已行义眼修复患者,取结膜囊内分泌物作细菌培养鉴定。制作自凝树脂、热凝树脂义眼片各50片,每组义眼片随机均分为5组,分别以清水、体积分数75%乙醇、Boston SIMPLUS、Polident及牙膏进行清洁,清洁完成后将试片进行残留生物膜培养,并运用菌落计数法评估不同处理方式的清洁效果。结果与结论:84例标本送检,阳性49例,其中金黄色葡萄球菌分离率14.29%,表皮葡萄球菌分离率占13.10%,麦氏棒杆菌分离率占7.14%。采用清水、Boston SIMPLUS、牙膏清洁时,自凝树脂组金黄色葡萄球菌菌落数高于热凝树脂组(P<0.05);采用乙醇、Polident清洁时,两组金黄色葡萄球菌菌落数无差异。在自凝树脂中,清水处理组菌落计数高于其他方法处理组(P<0.05),乙醇处理组菌落计数低于Boston SIMPLUS组(P<0.05),其余组间比较差异均无显著性意义;在热凝树脂中,清水处理组菌落计数高于其他方法处理组(P<0.05),其余组间比较差异均无显著性意义。表明乙醇、Boston SIMPLUS、Polident及牙膏清洗方法对两种义眼材料表面金黄色葡萄球菌生物膜的清除效果均优于清水冲洗,综合多因素,为避免义眼戴用后结膜囊内微生物感染的发生,鼓励选用Polident及Boston SIMPLUS清洁义眼片。

BACKGROUND： The micro-ecological environment has been broken when the ocular prosthesis was inset into the conjunctival sac. The recede of self cleaning function is more conducive to the microbial growth and colonization. The cleaning of plaque biofilm on ocular prosthesis surface affects the patient＇s wearing comfort and quality of life. It is necessary to seek an effective cleaning method. OBJECTIVE： To compare the clearance effect of five cleaning methods on the palque biofilm on ocular prosthesis surface. METHODS： The conjunctival secretions from 84 patients who were subjected to ocular prosthesis repair were taken for bacterial culture and identification. Fifty pieces of self-curing resin and thermosetting resin artificial eyes were produced. The artificial eyes in each group were randomly divided into five groups,and were cleaned respectively with clear water,volume fraction of 75% ethanol,Boston SIMPLUS,polident and toothpaste. Afterthe completion of the cleaning,the test piece was conducted residual biofilm culture. The clearance effects of different processing modes were evaluated using colony counting method. RESULTS AND CONCLUSION： Eighty-four specimens were submitted for inspection,of which 49 were positive. The Staphylococcus aureus separation rate was 14.29%. Staphylococcus epidermidis separation rate accounted for 13.10%. Maxwell Corynebacterium separation rate accounted for 7.14%. When water,Boston SIMPLUS and toothpaste were used for cleaning,the Staphylococcus aureus colony number in the self-curing resin group was higher than that in the thermosetting resin group（P〈0.05）; when ethanol and polident were used for cleaning,there was no difference in the Staphylococcus aureus colony number between these two groups. In self-curing resin,the colony count in the clear water treatment group was higher than that in the other treatment groups（P〈0.05）. The colony count in the ethanol treatment group was lower than that in the Boston SIMPLUS group（P〈0.05）. There was no significant difference in the colony count between other groups. In thermosetting resin,the colony count in the clear water treatment group was higher than that in the other treatment groups（P〈0.05）. There was no significant difference in the colony count between other groups. These results demonstrate that ethanol,Boston SIMPLUS,polident and toothpaste have better cleaning effects on Staphylococcus aureus biofilms on the surface of two kinds of ocular prostheses than the clear water rinse. Overall,it is encouraged to clean the artificial eyes using polident and Boston SIMPLUS,in order to avoid the occurrence of microbial infection in the conjunctival sac after wearing ocular prosthesis.