摘要
目的探讨超声乳化白内障吸除术后眼内炎的临床情况。方法随机选取2019年1月—2021年7月该院收治的白内障患者100例为研究对象,遵照随机抽样法分为两组,即甲组、乙组,各50例。所有患者均采用超声乳化白内障吸除术治疗,甲组给予左氧氟沙星+妥布霉素地塞米松滴眼液,乙组给予左氧氟沙星+妥布霉素地塞米松滴眼液+甲泼尼龙琥珀酸钠静滴,总结分析两组患者术后眼内炎发生情况、病原菌分布情况,同时比较两组患者手术前、手术后7 d炎性因子水平。结果甲组术后眼内炎发生率为2.00%,乙组发生率为16.00%,差异有统计学意义(χ^(2)=4.396,P<0.05)。9例术后眼内炎患者共培养分离病原菌8株,其中革兰阳性菌6株(表皮葡萄球菌4株,金黄色葡萄球菌1株,粪肠球菌1株),革兰阴性菌2株(肺炎克雷伯菌1株,铜绿假单胞菌1株)。术前甲组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平对比差异无统计学意义(P>0.05);但甲组术后7 d IL-6、TNF-α水平明显低于乙组,差异有统计学意义(P<0.05)。结论超声乳化白内障吸除术后眼内炎患者的病原菌主要是表皮葡萄球菌,应用左氧氟沙星+妥布霉素地塞米松滴眼液治疗时,能有效减轻炎性反应,临床应用价值高。
Objective To explore the clinical situation of endophthalmitis after phacoemulsification and cataract aspiration.Methods 100 cataract patients treated in the hospital from January 2019 to July 2021 were randomly selected and divided into two groups according to the randomly sampling method,namely group A and group B,with 50 cases in each group.All patients were treated with phacoemulsification cataract aspiration.Group A was given levofloxacin+tobramycin dexamethasone eye drops,and group B was given levofloxacin+tobramycin dexamethasone eye drops+methylprednisolone sodium succinate intravenous infusion,summarized and analyzed the occurrence of endophthalmitis and the distribution of pathogenic bacteria in the two groups of patients,and compared the levels of inflammatory factors in the two groups before and 7 days after the operation.Results The incidence of postoperative endophthalmitis was 2.00%in group A and 16.00%in group B,the difference was statistically significant(χ^(2)=4.396,P<0.05).9 cases of postoperative endophthalmitis patients were co-cultured and isolated 8 pathogens,including 6 Gram-positive bacteria(4 Staphylococcus epidermidis,1 Staphylococcus aureus,1 Enterococcus faecalis)and 2 Gram-negative bacteria(1 strain of Klebsiella pneumoniae,1 strain of Pseudomonas aeruginosa).Before the operation,there was no statistiaclly significant difference in the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)between group A and group B(P>0.05);but group A of the levels of IL-6 and TNF-αin the group 7 d after the operation were significantly lower than those of the group B,and the difference was statistically significant(P<0.05).Conclusion The pathogenic bacteria of endophthalmitis patients after phacoemulsification cataract aspiration is mainly Staphylococcus epidermidis.Application of levofloxacin+tobramycin dexamethasone eye drops treatment,it can effectively reduce the inflammatory reaction and has high clinical application value.
作者
敬志果
朱振涛
JING Zhiguo;ZHU Zhentao(Department of Ophthalmology,Huai'an Hospital,Huai'an,Jiangsu Province,223200 China)
出处
《中外医疗》
2021年第34期87-90,共4页
China & Foreign Medical Treatment
关键词
白内障
超声乳化白内障吸除术
眼内炎
病原菌
炎性因子
Cataract
Phacoemulsification cataract aspiration
Endophthalmitis
Pathogenic bacteria
Inflammatory factors
