[关键词]
[摘要]
目的:了解白内障复明手术中房水细菌污染现状。
方法:于2010-12/2012-12采集807例白内障复明手术患者术中房水及结膜囊标本进行细菌培养,并对结果进行研究分析。
结果:术中房水细菌培养平均阳性率0.93%,不同时间点房水细菌培养阳性率,差异无统计学意义; 术中结膜囊细菌培养平均阳性率9.54%,不同时间点结膜囊细菌培养阳性率差异显著,有统计学意义(χ2=37.21,P<0.01)。术中房水污染细菌种类大部分与结膜囊细菌一致,阳性菌株以表皮葡萄球菌所占比例最高,房水占60.00%,结膜囊占91.56%。连台手术>6台患者房水及结膜囊细菌培养的阳性率明显大于≤5台患者。药敏结果显示:房水及结膜囊大部分细菌均对头孢类较敏感,对青霉素、红霉素、四环素、洛美沙星耐药性较高。
结论:术中房水细菌污染大部分来自结膜囊,术前结膜囊无菌化准备至关重要; 术中结膜囊,甚至房水仍可能存在细菌,加强局部抗菌药物的应用,可有效地预防术后眼内感染发生。
[Key word]
[Abstract]
AIM: To learn about the current condition about bacteria contamination of aqueous humor during cataract operation.
METHODS: Bacterial culture was conducted of the samples of aqueous humor and conjunctival sac collected from 807 patients during cataract operation from December 2010 to December 2012. Then, the bacterial culture results were analyzed.
RESULTS: On average, the bacterial culture positive rate was 0.93%, with no significant difference in the positive rates of samples collected at different times. The average bacterial culture positive rate of conjunctival sac was 9.54%, with significant difference between the positive rates before and after the operation(χ2=37.21, P<0.01). Most of the bacteria types in aqueous humor were the same as those in the conjunctival sac, with most frequent strain being staphylococcus epidermidis(60.00% for aqueous humor and 91.56% for the conjunctival sac). During continuous operations, >6 times of patients' aqueous humor and the positive rate of conjunctival sac bacteria culture is significantly greater than that of ≤5 times of patients. The result of the drug sensitive test indicated that most bacteria in aqueous humor and conjunctival sac were sensitive to Cephalosporins while they were highly resistant to penicillin, erythromycin, tetracycline, and Lomefloxacin.
CONCLUSION:Because of the bacterial pollution in the water from most of the conjunctival sac, preoperative conjunctival sac aseptic preparation is essential. Because intraoperative conjunctival sac, even real water may have some bacteria, strengthen the local application of antibiotics can effectively prevent postoperative intraocular infection.
[中图分类号]
[基金项目]
广西自治区卫生厅项目(No.Z2011506)