白内障术前预防性用药效果及舒适性评价
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摘要：目的了解白内障术前预防性用抗生素的效果及舒适性。方法108例、108眼白内障患者，术前随机使用氧氟沙星(泰利必妥)、左氧氟沙星(海伦)、妥布霉素(信妥明)滴眼液，按每1 h滴药1次×1 d及每1 d用药4次×3 d两种方式用药。分别于用药后5，15 min，1 d或3 d询问患者干涩、异物、烧灼、眼痒、眼疼、畏光等感觉并评分以了解用药的舒适性。用裂隙灯显微镜观察结膜充血、结膜水肿、结膜乳头与滤泡、角膜荧光素染色情况以了解药物的毒性作用。用药1 d或3 d后结膜囊取材作细菌培养了解药物的疗效。结果滴用妥布霉素滴眼液5，15 min后，各项舒适性指标积分总和均升高(P<0.01)。滴用左氧氟沙星及氧氟沙星滴眼液仅在滴药5 min后，各项舒适性指标积分总和轻微升高(P<0.05)，滴药15 min后消失(P>0.05)。各项不适症状中以眼痛及烧灼感发生频率最高，程度最重。滴用妥布霉素滴眼液5，15 min后，各项毒性作用指标积分总和均较滴用前增加(P<0.05)，用左氧氟沙星及氧氟沙星滴眼液仅在用药后5 min上述指标积分总和较用药前增高(P<0.05)，其余时间与用药前比较无差异(P>0.05)。其毒性作用主要表现为结膜充血。用药组结膜囊细菌培养均为阴性。结论妥布霉素、左氧氟沙星、氧氟沙星滴眼液采用每1 h 1次×1 d及每1 d 4次×3 d给药均有良好的预防性用药的效果，左氧氟沙星及氧氟沙星的舒适性更好，毒性更小。
关键词：白内障；妥布霉素；左氧氟沙星；氧氟沙星；滴眼液
中图分类号：R776.1文献标识码：A文章编号：1672-979X(2007)01-0021-03
Evaluation of Effect and Comfort of Three Prophylactic Antibiotics
on Pre-operation Cataract Patients
CHEN Zhe, XIAO Qi-guo, CHEN Yuan, FEI Zhi-gang, DU Juan
(The Second Affiliated Hospital, Nanhua University, Hengyang421001,China)
Abstract：Objective To evaluate the effect and comfort of three prophylactic antibiotic eye drops (ofloxacin, levofloxacin and tobramycin) on the pre-operation cataract patients. Methods One hundred and eight cataract patients (108 eyes) were randomly divided into six groups and respectively used ofloxacin (Tarivid) eye drops (one time every hour×1d, and four times every day×3d), levofloxacin (Hailun) eye drops (one time every hour×1d, and four times every day×3d) and tobramycin (Xintuoming) eye drops(one time every hour×1d, and four times every day×3d). The discomfort symptoms (dryness, foreign body sensation, ambustio sensation, itching, pain and photophobia) and toxic reactions (conjunctival congestion, conjunctival edema, conjunctival papilla and follicle, fluorescence stain) were evaluated after dripping for 5 minutes, 15 minutes and one day (or three days) ......
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