Gawrońska Małgorzata, Kałuzny Józef, Mikucka Agnieszka, Gospodarek Eugenia
Z Katedry i Kliniki Chorób Oczu Akademii Medycznej w Bydgoszczy.
Klin Oczna. 2005;107(7-9):408-13.
170 patients with senile cataract were examined. Before admission to Ophthalmology Department each patient received 0.3% gentamicin solution three times a day. All patients had their conjunctival sac disinfected with the use of 5% PVP-Jodi before surgery. Patients were divided into two groups. In the first group (120 patients), first samples were taken on admission to the Ophthalmology Department. Next in the day of the procedure, in the operation room--first before and second after disinfection of conjunctival sac. Adhesive foil was not used in this group. In the second group (50 patients), we used adhesive foil before surgery and samples were taken before and after disinfection of conjunctival sac.
On admission, positive cultures were obtained in 40.0% cases. Most of the bacterial flora were Gram-positive bacteria. The number of the positive cultures before disinfection with 5.0% PVP-Jodi solution diminished to 5.8%, compared with positive results obtained on admission to the Ophthalmology Department. Secondary infection of the conjunctival sac has been revealed in 10% after disinfection with the use of the 5.0% PVP Jodi. It was due to bacterial flora coming from the skin and limbs of the lids (in the group without adhesive foil), whereas positive samples were obtained in 2.0% in the group where adhesive foil was used.
1）评估结膜囊的微生物菌群以及分离出的微生物对用于结膜囊消毒的0.3%庆大霉素溶液和5.0%聚乙烯吡咯烷酮碘溶液的敏感性。2）评估粘贴薄膜在预防手术区域感染中的作用。
对170例老年性白内障患者进行检查。在眼科住院前，每位患者每天使用0.3%庆大霉素溶液滴眼3次。所有患者在手术前均使用5%聚乙烯吡咯烷酮碘对结膜囊进行消毒。患者分为两组。第一组（120例患者），在眼科住院时采集首次样本。在手术当天，在手术室——结膜囊消毒前和消毒后分别采集样本。该组未使用粘贴薄膜。第二组（50例患者），在手术前使用粘贴薄膜，并在结膜囊消毒前后采集样本。
住院时，40.0%的病例培养结果为阳性。大多数细菌菌群为革兰氏阳性菌。与眼科住院时获得的阳性结果相比，使用5.0%聚乙烯吡咯烷酮碘溶液消毒前阳性培养物的数量降至5.8%。使用5.0%聚乙烯吡咯烷酮碘消毒后，结膜囊继发感染率为10%。这是由于细菌菌群来自皮肤和眼睑边缘（未使用粘贴薄膜的组），而使用粘贴薄膜的组阳性样本率为2.0%。
1）庆大霉素可显著减少白内障手术前患者结膜囊中细菌菌群的数量。2）粘贴薄膜可有效保护手术区域免受感染。
