摘要
目的分析老年糖尿病患者白内障围手术期感染的病原菌构成及特点,对抗菌药物的应用及效果进行探讨,以期为提高临床对老年糖尿病白内障患者围手术期感染诊治水平提供参考。方法回顾性分析医院2009年1月-2013年1月69例糖尿病患者白内障围手术期感染临床资料,分析患者围手术期抗菌药物的应用情况;采用SPSS13.0软件进行统计分析。结果 69例患者术前结膜囊细菌培养阳性54例、术后切口感染13例、眼内感染2例;病原菌培养主要为革兰阳性菌,其中以表皮葡萄球菌为主,共41株占59.42%,革兰阴性菌以铜绿假单胞菌为主,共5株占6.33%,培养出真菌3株,均为白色假丝酵母菌,占4.35%;具有抗菌药物适应证的患者仅11例,无适应证用药的58例占84.06%;术前给药时间合理的30例占43.48%;100.00%的患者术后用药时间>24h,66例患者为全身性用药,占95.65%,以上指标均具有代表性(P<0.05);全身静脉用药以头孢呋辛钠为主,37例占30.58%;另有少数患者使用头孢唑林和左氧氟沙星,局部滴眼或球结膜下注射药物分别是庆大霉素注射液、妥布霉素/地塞米松滴眼液、左氧氟沙星滴眼液、氯霉素滴眼液。结论高龄与糖尿病均是感染发生的高危因素,合理使用抗菌药物,加强手术的无菌控制及围手术期的血糖控制是降低感染的有效手段。
／ OBJECTIVE To analyze the distribution of pathogens causing infections in elderly patients with diabetes during perioperative period of cataract surgery and explore the effect of use of antibiotics so as to improve the level of diagnosis and treatment of the perioperative infections. METHODS From Jan 2009 to Jan 2013, the clinical data of totally 69 diabetes patients complicated with perioperative infections were retrospectively analyzed, then the use of antibiotics during the perioperative period was analyzed, and the statistical analysis was performed with the use of SPSS13.0 software. RESULTS Of the 69 patients, there wer6 54 cases with conjunctival sac cultured positive, 13 cases of postoperative incision infections, and 2 cases of eye infections. The gram-positive bacteria were dominant among the pathogens, among which there were 41 （59.42%） strains of Staphylococcus epidermidis; the Pseudomonas aeruginosa （5 strains） was the predominant species of gram-negative bacteria, accounting for 6.33 % ; totally 3 strains of fungi have been isolated, all of which were Candida albicans, accounting for 4.35 %. There were only 11 patients with the indications of antibiotics and 58 （84. 06%） cases without indications of antibiotics; there were 30 （43.38%） cases with reasonable time of premedication; 100.00% of the patients have used antibiotics for more than 24 hours; 66 cases were treated with systemic administration of drugs, with all the above indicator representative（P〈0.05）; there were 37 （30.58%） cases treated with the systemic intravenous administration of cefuroxime sodium; few patients used cefazolin and levofloxaxin; gentamicin injection, tobramycin- dexamethasone eye drops, levofloxacin eye drops, and chloramphenicol eye drops were used for local eye drops or subconjunctival injection. CONCLUSION The advanced age and diabetes are the high risk factors for the infections;it is an effective way to reasonably use antibiotics and strengthen the control of aseptic surgery as well as the
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第6期1504-1506,共3页
Chinese Journal of Nosocomiology
基金
吉安县科技局专项基金项目(ZJ-2008B-042)
关键词
老年患者
糖尿病
白内障
围手术期
感染
病原菌
抗菌药物
Elderly patients Diabetes s Perioperative period of cataracts Infections Pathogens Antibiotic
