前房注射头孢呋辛对白内障术后眼内炎的预防效果观察(1)
【摘要】 目的：探讨前房注射头孢呋辛对白内障术后眼内炎的预防效果。方法：选取2017年12月-2019年12月于笔者所在医院行超声乳化白内障摘除术患者300例，随机分为研究组与对照组各150例，对照组术毕后前房未予注入药物，研究组术毕后于前房注入头孢呋辛。比较两组术前与术后3 d血清肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)与白细胞计数(WBC)水平，比较术后疼痛状况及术后7 d内眼内炎发生情况。结果：术后3 d研究组TNF-α、hs-CRP与WBC水平均低于对照组(P<0.05);观察组术后疼痛状况优于对照组(P<0.05);术后7 d内研究组眼内炎发生率低于对照组(P<0.05)。结论：白内障术中予前房注射头孢呋辛可降低患者炎症因子水平，有效预防术后眼内炎的发生，减轻术后疼痛。
【关键词】 头孢呋辛 白内障手术 眼内炎 炎症因子
doi：10.14033/j.cnki.cfmr.2020.20.057 文獻标识码 B 文章编号 1674-6805(2020)20-0-03
Preventive Effect of Intracameral Injection of Cefuroxime on Endophthalmitis after Cataract Surgery/YANG Sha， HE Jianqiang， CHEN Bowen. //Chinese and Foreign Medical Research， 2020， 18(20)： -140
[Abstract] Objective： To explore the preventive effect of intracameral injection of cefuroxime on endophthalmitis after cataract surgery. Method： From December 2017 to December 2019， 300 patients who underwent phacoemulsification in the authors’ hospital were randomly divided into the study group and the control group， 150 cases in each group. After surgery， the control group was not given intracameral injection of drugs， while study group was given intracameral injection of Cefuroxime. The levels of serum tumor necrosis factor-α (TNF-α)， high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) before surgery and at 3 d after surgery， postoperative pain and the occurrence of endophthalmitis within 7 d after surgery were compared between the two groups. Result： At 3 d after surgery， levels of TNF-α， hs-CRP and WBC in the study group were lower than those in the control group (P<0.05). The postoperative pain in the study group was milder than that in the control group (P<0.05). Within 7 d after surgery， incidence of endophthalmitis in the study group was lower than that in the control group (P<0.05). Conclusion： Intracameral injection of Cefuroxime during cataract surgery can reduce the levels of inflammatory factors in patients， effectively prevent the occurrence of postoperative endophthalmitis and alleviate postoperative pain.
[Key words] Cefuroxime Cataract surgery Endophthalmitis Inflammatory factor
First-author’s address： Taishan People’s Hospital， Taishan 529200， China
白内障好发于中老年人，其是由外伤、代谢异常、营养障碍与老化等多种因素共同导致晶状体蛋白质变性混浊进而致使光线投射受到阻碍，随着病情发展，患者出现视物障碍甚至发生眼盲，随着年龄增长而白内障发病率也随之上升[1]。目前白内障可使用药物与手术两种方式进行治疗，白内障初期可使用药物治疗对病情进行改善，白内障进展较快，成熟期往往药物治疗效果不佳，进而常使用超声乳化白内障摘除术进行治疗，但容易出现视力下降、前房渗出、玻璃体混浊与睫状充血等并发症，同时会导致部分患者出现感染性眼内炎，眼内炎会导致视功能等受到严重损伤，可对健康产生严重损害，在围手术期最大限度降低眼内炎发生率具有重要的意义，虽在围手术期使用广谱抗生素滴眼液可降低眼内炎发生，但效果不尽理想[2]。有学者研究显示在白内障摘除术中前房注射头孢呋辛具有一定预防感染的效果[3]。故探讨前房注射头孢呋辛对白内障术后眼内炎的预防效果。, http://www.100md.com(杨莎 何健强 陈博文)
【关键词】 头孢呋辛 白内障手术 眼内炎 炎症因子
doi：10.14033/j.cnki.cfmr.2020.20.057 文獻标识码 B 文章编号 1674-6805(2020)20-0-03
Preventive Effect of Intracameral Injection of Cefuroxime on Endophthalmitis after Cataract Surgery/YANG Sha， HE Jianqiang， CHEN Bowen. //Chinese and Foreign Medical Research， 2020， 18(20)： -140
[Abstract] Objective： To explore the preventive effect of intracameral injection of cefuroxime on endophthalmitis after cataract surgery. Method： From December 2017 to December 2019， 300 patients who underwent phacoemulsification in the authors’ hospital were randomly divided into the study group and the control group， 150 cases in each group. After surgery， the control group was not given intracameral injection of drugs， while study group was given intracameral injection of Cefuroxime. The levels of serum tumor necrosis factor-α (TNF-α)， high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) before surgery and at 3 d after surgery， postoperative pain and the occurrence of endophthalmitis within 7 d after surgery were compared between the two groups. Result： At 3 d after surgery， levels of TNF-α， hs-CRP and WBC in the study group were lower than those in the control group (P<0.05). The postoperative pain in the study group was milder than that in the control group (P<0.05). Within 7 d after surgery， incidence of endophthalmitis in the study group was lower than that in the control group (P<0.05). Conclusion： Intracameral injection of Cefuroxime during cataract surgery can reduce the levels of inflammatory factors in patients， effectively prevent the occurrence of postoperative endophthalmitis and alleviate postoperative pain.
[Key words] Cefuroxime Cataract surgery Endophthalmitis Inflammatory factor
First-author’s address： Taishan People’s Hospital， Taishan 529200， China
白内障好发于中老年人，其是由外伤、代谢异常、营养障碍与老化等多种因素共同导致晶状体蛋白质变性混浊进而致使光线投射受到阻碍，随着病情发展，患者出现视物障碍甚至发生眼盲，随着年龄增长而白内障发病率也随之上升[1]。目前白内障可使用药物与手术两种方式进行治疗，白内障初期可使用药物治疗对病情进行改善，白内障进展较快，成熟期往往药物治疗效果不佳，进而常使用超声乳化白内障摘除术进行治疗，但容易出现视力下降、前房渗出、玻璃体混浊与睫状充血等并发症，同时会导致部分患者出现感染性眼内炎，眼内炎会导致视功能等受到严重损伤，可对健康产生严重损害，在围手术期最大限度降低眼内炎发生率具有重要的意义，虽在围手术期使用广谱抗生素滴眼液可降低眼内炎发生，但效果不尽理想[2]。有学者研究显示在白内障摘除术中前房注射头孢呋辛具有一定预防感染的效果[3]。故探讨前房注射头孢呋辛对白内障术后眼内炎的预防效果。, http://www.100md.com(杨莎 何健强 陈博文)