眼科Ⅰ Ⅱ类切口手术抗生素应用与否临床观察

Clinical observation of antibiotic application in operation of ophthalmic Ⅰ, Ⅱ type incision

目的观察眼科Ⅰ、Ⅱ类切口围手术期是否需要预防性全身应用抗生素。方法回顾分析解放军第474医院眼科在两个阶段随机抽取2组病例：A组：2010年1月至2012年1月收治的各民族200例（248只眼）眼科Ⅰ类白内障超声乳化人工晶状体植入手术及Ⅱ类慢性泪囊炎泪囊鼻腔吻合手术，所有病例均预防性全身应用抗生素。B组：2012年2月至2014年1月200例（260只眼）眼科Ⅰ、Ⅱ类同样病种手术，医院采取强制性行政干预等措施，眼科医生按照卫生部颁布的《抗生素药物临床应用指导原则》严格执行，在术前、术中、术后均在眼局部应用抗菌滴眼液治疗，未全身应用抗生素。结果眼科Ⅰ、Ⅱ类手术全身预防性应用抗生素与干预后全身未应用抗生素两者治疗结果（x2=0．123，P=0．79）无统计学意义。术后随访半年没有出现眼部感染情况。结论眼科Ⅰ、Ⅱ类切口手术围手术期无需预防性全身应用抗生素，采取眼局部应用抗生素治疗，结果安全有效，对于全社会不滥用抗生素具有重要的指导意义。

Objective To observe that preventive perioperative ophthalmic operation of I,II type incision. application of antibiotic was unnecessary in Methods Retrospective analysis of our hospi- tal in two phase randomly selected cases： Group A：Between January 2010 and January 2012, 200 cases （248 eyes） of various nationalities eye I type of cataract ultrasonic emulsification intraocular lens implant surgery and II chronic dacryocystitis lacrimal sac nasal cavityanastomosis operation, all cases for prophylactic systemic application of antimicrobial agents ; Group B： In February 2012 to January 2014, 200 cases （260 eyes） of eye I, II same disease to surgery, hospital take mandatory ad- ministrative intervention measures, ophthalmic doctor issued by the ministry of health of the clini- cal application of antibiotic guiding principles strictly carry out, all cases of preoperative and postop- erative systemic application of antibiotic, but in the preoperative, intraoperative and postoperative topi- cal application antibiotic eyedrops in eye treatment. Result The statistical results showed eye I, II operation body after the prophylactic use of antibiotics and intervention body without application of antimicrobial treatment was no difference（x2 =0.123,P =0.79）, no eye infection case postoperative fol- low-up of six months. Conclusion Ophthalmic operation of I,II type incision without perioperative use of prophylactic systemic application of antimicrobial agents, local application of antibiotics, main- ly take the eye, The result was safety and effective, it was great significance to guide rational use antibiotic