青霉素局部应用治疗新生儿淋菌性结膜炎的临床体会

Experience on penicillin topical administration in neonatal gonococcal conjunctivitis

目的 探讨局部应用青霉素治疗新生儿淋菌性结膜炎的临床效果。方法 2009年5月—2015年5月在我院住院治疗的新生儿淋球菌结膜炎患者20例,青霉素皮试（-）者18例,青霉素皮试（＋）者2例。青霉素皮试（-）者予以1∶4000青霉素溶液冲洗患眼结膜囊,1∶2000青霉素溶液滴眼;青霉素皮试（＋）者予以生理盐水100 ml冲洗结膜囊,并滴用妥布霉素眼液。结果 18例青霉素皮试（-）患儿中有1例治疗3 d病情好转后出院,余17例患儿住院5~8 d均治愈出院;2例青霉素皮试（＋）者治疗2 d眼部症状稍有减轻,应家属要求出院。结论 青霉素是治疗新生儿淋菌性结膜炎的首选药物,局部应用可以在保证疗效的基础上,避免静脉穿刺等给患儿带来的不适,并大大降低发生药物不良反应的几率。

OBJECTIVE To investigate effect of topical application of penicillin on neonatal gonococcal conjunctivitis. METHODS From May 2009 to May 2015, 20 patients with neonatal gonococcal conjunctivitis in our hospital were included. Eighteen patients were with negative penicillin skin test result while the rest 2 cases were of positive penicillin skin test outcome. Former cases were treated with penicillin solution （1 penicillin： 4000physiolog- ical saline） irrigation for conjunctiva sac in addition to penicillin solution eye drops （lpenicillin： 2000physiological saline） ; while the latter cases were administered with 100 ml saline water irrigation for conjunctival sac as well as tobramycin drops. RESULTS Of the 18 cases with negative penicillin skin test result, 1 case was improved and discharged 3 days alter treatment, me rest l / cases were cureu and discharged between 5 - 8 days after admitted; The 2 cases of positive result of penicillin test were mitigated in symptoms and were discharged at day 2 of hospitalization on request of their relatives. CONCLUSIONS Penicillin was the premier choice for neonatal gonococcal conjunctivitis, and topical application provided favorable effects while avoided damage of venipuncture. Moreover, it also decreased the risk of adverse effects dramatically.