妥布霉素滴眼液与盐酸左氧氟沙星滴眼液治疗儿童细菌性结膜炎的效果对比

Comparison on effect of tobramycin eye drops versus levofloxacin hydrochloride eye drops on bacterial conjunctivitis in children

目的比较妥布霉素滴眼液和盐酸左氧氟沙星滴眼液治疗儿童细菌性结膜炎的临床效果。方法抽取郑州大学附属儿童医院2019年10月至2021年6月收治的280例儿童细菌结膜炎患者,按随机数字表法分为对照组137例(盐酸左氧氟沙星滴眼液治疗)和观察组143例(妥布霉素滴眼液治疗),比较两组临床效果、眼表状况、结膜炎细菌敏感性和不良反应发生情况。结果治疗后,观察组总有效率(95.80%,137/143))高于对照组(88.32%,121/137),P<0.05。治疗前,两组泪膜破裂时间(BUT)和基础泪液分泌试验(SIt)水平比较差异未见统计学意义(P>0.05);治疗后,两组BUT、SIt较治疗前均上升,且观察组比对照组上升更显著(P<0.05)。从患者结膜囊分泌物鉴定出四种主要的细菌为表皮葡萄球菌、金黄色葡萄球菌、肺炎链球菌及流感嗜血杆菌,敏感试验表明前三种细菌对妥布霉素滴眼液的敏感性分别为87.80%(223/254)、73.13%(49/67)、75.79%(72/95),高于对盐酸左氧氟沙星滴眼液的敏感性[77.95%(198/254)、65.67%(44/67)、62.11%(59/95)],P<0.05;流感嗜血杆菌对妥布霉素滴眼液与盐酸左氧氟沙星滴眼液的敏感性比较差异未见统计学意义(P>0.05)。观察组用药后的不良反应发生率(4.90%,7/143)低于对照组(7.30%,10/137),P>0.05。结论盐酸左氧氟沙星滴眼液和妥布霉素滴眼液治疗儿童细菌性结膜炎均有较好效果,且妥布霉素滴眼液的疗效优于盐酸左氧氟沙星滴眼液。

Objective To compare the effects of tobramycin eye drops and levofloxacin hydrochloride eye drops in the treatment of children with bacterial conjunctivitis.Methods A total of 280 children with bacterial conjunctivitis were selected,and they were divided into control group(137 children treated with levofloxacin hydrochloride eye drops)and observation group(143 children treated with tobramycin eye drops)according to the random number table method.Curative effect,ocular surface conditions,bacterial susceptibility,and adverse reactions were compared between the two groups.Results After treatment,the total effective rate in the observation group(95.80%,137/143)was higher than that in the control group(88.32%,121/137),P<0.05.There was no statistically significant difference in tear film break-up time(BUT)or Schirmer test(SIt)before treatment(P>0.05).After treatment,BUT and SIt were increased in the two groups,and the increases of the observation group were more significant than those of the control group(P<0.05).Staphylococcus epidermidis,Staphylococcus aureus,Streptococcus pneumoniae and Haemophilus influenzae were four main bacteria isolated from conjunctival secretions.Susceptibility test showed that the sensitivity of the first three kinds of bacteria to tobramycin eye drops were 87.80%(223/254),73.13%(49/67),75.79%(72/95),respectively,significantly higher than the 77.95%(198/254),65.67%(44/67),62.11%(59/95)to levofloxacin hydrochloride eye drops(P<0.05).There was no significant difference in the sensitivity of Haemophilus influenzae to tobramycin eye drops and levofloxacin hydrochloride eye drops(P>0.05).The incidence of adverse reactions in the observation group(4.90%,7/143)was significantly lower than that in the control group(7.30%,10/137),P>0.05.Conclusions Both of tobramycin eye drops and levofloxacin hydrochloride eye drops are effective in the treatment of bacterial conjunctivitis in children.Tobramycin eye drops is more effective than levofloxacin hydrochloride eye drops.