【摘要】 目的探讨0.3%氧氟沙星滴眼液手术前点眼以及结膜囊冲洗对预防LASIK术后感染的作用。方法行准分子激光治疗的近视眼患者92例183眼,手术前结膜囊冲洗前后分别做结膜囊分泌物细菌培养。结果未点眼组和点眼1、2、3、4d组结膜囊冲洗前细菌培养阳性率分别为21.21%(7/33)、19.19%(19/99)、22.22%(4/18)、5.88%(1/17)和31.25%(5/16);点眼1、2、3、4d组与未点眼组相比,经统计学处理,差异均无显著性(P>0.05,χ2=3.294)。结膜囊冲洗前细菌培养阳性率19.67%,冲洗后阳性率4.92%,经统计学处理具有显著性差异(P<0.01,χ2=18.47)。在培养阳性的45眼中,葡萄球菌39眼,占87.7%,杆菌6眼,占13.3%。结论结膜囊细菌培养阳性者中以葡萄球菌为主,LASIK术前充分的结膜囊冲洗是预防术后感染的重要措施,抗生素点眼应选择对球菌作用强兼顾杆菌的有效抗生素或联合用药。更多还原

【Abstract】 ObjectiveTo evaluate the topical prophylaxis of 0.3% ofloxacin and conjunctiva sac washing for post-lasik infection.Methods183eyes of 92consecutive myopic patients were enrolled in presented study during March-April in 2004 at Henan Institute of Ophthalmology.0.3% of ofloxacin was topically dripped for 1,2,3 and 4days separately in 4groups and drops was not used as control group.Conjunctiva bacterial culture was done before and after conjunctiva sac washing with normal saline+gentamicin.The effects of topical prophylaxis with 0.3% ofloxacin and conjunctiva sac washing were evaluated.ResultsThe positive rate of bacterial culture was 21.21%(7/33) before conjunctiva sac washing in control group,and that in 1-day group was 19.19%(19/99) and 22.22%( 4/18) in 2-day group,31.25%(1/17) in 3day-group and 31.25%(5/16) in 4-day group without statistically significant difference in comparison with control group.In all 183eyes,bacterial culture positive rate was 19.67%(36/183) before conjunctiva sac washing and 4.92% (9/183) after washing with a significant difference between them (χ 2 =18.47,P<0.01).Bacterial culture showed that Gram-positive cocci was the main source of infection in 87.5% ( 28/32 ),including coagulase-negative staphyloccus in 75%(24eyes) and staphyloccus aureus in 12.5%(4eyes).Gram-negative rods was 12.5%(4/32)including pseudomonas in 3.125%(1eye),coryneform bacteria in 3.125%(1eye)and sporebacteria in 6.25%(2eyes).ConclusionStaphyloccus is the main bacterium in normal conjunctiva sac.Conjunctiva washing with broad- spectrum antibiotics in pre-lasik plays an important role in preventing postoperative infection.更多还原