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[摘要]
目的:分析兜带式后巩膜加固术治疗病理性近视的术后发生感染情况。
方法:分析2014-06/12期间本院采用兜带式后巩膜加固术治疗病理性近视的167例患者临床资料,统计术后感染率、病原菌耐药情况,分析术后发生感染的相关因素。
结果:患者167例286眼中,术后10例18眼发生感染,患眼感染率6.3%,10例18感染眼分泌物培养出病原菌30株,其中金黄色葡萄球菌10株,表皮葡萄球菌10株,肺炎克雷伯菌6株,铜绿假单胞菌感染4株。革兰阳性菌对青霉素、氨苄西林、环丙沙星耐药率较高,对万古霉素敏感,革兰阴性菌对头孢噻肟的耐药率较高,对亚胺培南耐药率低。两组手术患者的年龄、文化水平、手术时间、术者实施手术次数、术中护理配合人员年资、患者术后用药依从率比较差异有统计学意义(P<0.05),这些因素有可能与兜带式后巩膜加固术术后感染相关。
结论:兜带式后巩膜加固术后感染,由葡萄球菌引起的感染最常见,对万古霉素敏感,革兰氏阴性菌对亚胺培南较为敏感。缩短手术时间,采用有经验的护理人员进行配合,减少患者手术次数,提高患者用药依从性,有助于降低术后感染。
[Key word]
[Abstract]
AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement.
METHODS: The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed.
RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6.3% in 10 patients(18 eyes). There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant(P<0.05), which related to the infection after pocket scleral reinforcement.
CONCLUSION: The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.
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