白内障手术术前眼部消毒的最佳证据总结

Evidence summary of ocular disinfection before cataract surgery

目的:评价总结国内外关于白内障手术术前眼部消毒方法的最佳证据,为预防白内障手术术后眼内炎提供证据支持。方法:系统检索中国生物医学文献数据库、Joanna Briggs Institute(JBI)、美国国立临床诊疗指南数据库(NGC)、澳大利亚临床实践指南数据库、新西兰指南工作组、加拿大医学会临床实践指南信息库、英国国家卫生与服务优化研究院(NICE)等数据库内关于白内障手术术前眼部消毒的相关证据,包括指南、最佳实践信息册、证据总结、随机对照研究等。检索时间从建库至2021年10月24日。由3名研究者对文献质量进行评价和内容提取。结果:共纳入7篇指南,内容包括白内障手术术前眼部消毒时消毒液种类选择、消毒液浓度选择、消毒范围、作用时间、消毒时机等。结论:选择适宜的消毒剂,采用正确的方法对白内障手术患者进行术前的眼部消毒,以减少眼周及结膜囊菌群,从而预防患者术后眼内炎的发生,保证患者安全。由于证据的不断更新及护理的人文属性,在应用证据时应结合医院环境及临床特点有针对性地加以选择。

Objective:To evaluate and summarize the best evidence of ocular disinfection before cataract surgery,and to provide evidence support for the prevention of endophthalmitis after cataract surgery.Methods:Chinese biomedical literature database and Joanna Briggs Institute(JBI),National Clinical Guidelines Database(NGC),Australian Clinical Practice Guidelines Database,New Zealand Guidelines Group,Canadian Medical Association CPG Network,UK National Institute for Health and Service Excellence(NICE),and other databases were retrieved,researches on ocular disinfection before cataract surgery including guidelines,best practice information book,evidence summary and randomized controlled trials were extracted systematically.The retrieval time is from inception to October 24,2021.Three researchers evaluated the quality of literatures and extracted the contents.Results:A total of 7 guidelines were included.The evidence included the type of disinfectant,the concentration of disinfectant,the scope of disinfection and the time of disinfection.Conclusion:The nursing staff should choose appropriate disinfectant and use correct method to disinfect the eyes before operation,so as to reduce the bacteria community around the eyes and conjunctival sac and prevent the occurrence of endophthalmitis after operation,to ensure the safety of patients.Due to the continuous updating of evidence and humanistic nature of nursing,evidence should be selected pertinently combining with hospital environment and clinical characteristics when the evidences were applied.