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比较聚维酮碘冲洗结膜囊对糖尿病和非糖尿病白内障患者的消毒效果(重投)
Comparison of the efficacy of conjunctival irrigation by povidone-iodine between diabetic and non-diabetic patients undergoing cataract surgery
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DOI:
作者:
窦懿行,陈丽,李冰,盛敏杰
Yixing Dou,Li Chen, Bing Li, Minjie Sheng
作者单位:
上海杨思医院眼科,同济大学附属第十人民医院眼科,同济大学附属第十人民医院眼科,同济大学附属第十人民医院眼科
Department of Ophthalmology, Shanghai Yangsi Hospital, 200126, China Department of Ophthalmology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, 200072, China
关键词:
眼内炎;糖尿病;白内障;聚维酮碘
Endophthalmitis;Diabetes;Cataract;Povidone-iodine
摘要:
目的:比较1% 聚维酮碘冲洗结膜囊对糖尿病和非糖尿病白内障手术患者的消毒效果。方法:施行白内障手术的患者分为非糖尿病组(组1, n1=19例)和糖尿病组(组2, n2=17例)。取四个时刻的结膜囊标本(T0C:术前非手术眼-基线;T0:左氧氟沙星眼液消毒后且聚维酮碘冲洗前;T1:聚维酮碘冲洗后;T2:手术结束时)并接种到血/巧克力琼脂培养基和成巯基乙酸盐肉汤培养基中,培养5天后记录细菌菌群结果。结果:非手术眼结膜囊标本的细菌检测阳性率在两组中具有统计学差异(p <0.001 )。两组患者经10ml 1%聚维酮碘进行结膜囊冲洗后,菌落数量均较冲洗前显著减少 (p<0.05),且两组的细菌培养阳性率具有显著的统计学差异(p<0.05)。凝固酶阴性葡萄球菌是最常见的结膜囊菌株。结论:1% 聚维酮碘冲洗结膜囊能有效减少内眼术前的结膜囊菌群。糖尿病患者结膜囊菌群数量及种类较非糖尿病患者多。对术后眼内炎高危人群糖尿病患者应采用系统化规范的消毒策略。
Objective To compare the effectiveness of conjunctival irrigation by 1% povidone-iodine between diabetic and non-diabetic patients undergoing cataract surgery. Methods Patients scheduled for cataract surgery taken part in this study from November 2013 to January 2014 in Shanghai Yangsi hospital. All patients were divided into non-diabetic group (Group 1,19 patients) and diabetic group (Group 2,17 patients). The conjunctiva specimens were taken at four time-points: T0C – baseline from control eye before surgery; T0 – After levofloxacin 4 times and before irrigation of povidone-iodine from operate eye; T1 – After irrigation of 10 mL 1% povidone-iodine from surgery eye; T2 – After surgery from operated eye. All specimens were incubated on blood agars, chocolate agars and thioglycolate broth cultures for 5 days. The results were recorded. Results A total of 36 patients enrolled in the study, the positive rate of conjunctiva bacteria from non-surgical eyes has no significant difference between the two groups (p>0.05). After 10 mL povidone-iodine irrigation, a considerable reduction in the conjunctival bacterial load occurred in both groups (p<0.05); and bacteria culture positive rate was statistically significant difference between group 1 and group 2 (p<0.05). Coagulase-negative staphylococcus was the most commonly isolated bacteria in both groups. Conclusions Conjunctival irrigation by 1% povidone-iodine reduced the conjunctival bacteria significantly. More conjunctival bacteria flora were found in diabetic patients compared to non-diabetic patients. Therefore, we recommend strictly standardized preoperative prophylaxis should be used before intraocular surgery, especially for the diabetes patients who were considered to be the patients with high-risk postoperative endophthalmitis.
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