眼科诊断用接触镜的消毒现状及消毒效果比较
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第三军医大学西南医院护理科技创新基金


Comparison of different diagnostic contact lens disinfection methods used in ophthalmic department in Chinese hospitals
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Supported by Nursing Research Innovation Funding of Southwest Hospital of Third Military Medical University of China.

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    摘要:

    目的:调查国内医院对眼科诊断用接触镜的消毒现状,评估其消毒效果。

    方法:采用方便抽样的方法对10所医院进行调查,发现氯霉素滴眼液冲洗、75%乙醇搽拭和0.05%的二氯异氰尿酸钠(NaDCC)浸泡是目前我国临床最常用的眼科诊断用接触镜消毒方法。将被金黄色葡萄球菌、表皮葡萄球菌或铜绿假单胞菌污染的眼科检查用接触镜,用上述三种消毒剂按照以下方式进行消毒:1)擦拭; 2)浸泡消毒5min; 3)浸泡消毒10min,n=9. 然后镜面采样,对细菌群落培养并计数以评估细菌量,观察消毒效果。同时评估消毒后镜头的清晰度。

    结果:细菌负荷量为1×108/mL×50μL/镜头等于5×106/镜头。NaDCC或乙醇消毒显著降低了细菌量; 擦拭消毒时,75%的乙醇和NaDCC的消毒效果与氯霉素滴眼液比较差异显著(P≤0.01),但不能达到临床消毒要求,仍然存在交叉感染的风险。浸泡消毒效果与时间正相关,75%的乙醇和NaDCC浸泡10min最有效,能完全达到临床消毒要求,氯霉素滴眼液浸泡10min仍然不能达到临床要求。但乙醇会影响镜头的清晰度。

    结论:NaDCC浸泡消毒10min 或更长时间是一种简单有效的眼科诊断用接触镜消毒方法。

    Abstract:

    AIM:To assess the disinfection methods of diagnostic contact lens and their efficacy in ophthalmology in China.

    METHODS: Ten Chinese hospitals were surveyed and indicated three commonly used disinfectants 0.05% sodium dichloroisocyanurate(NaDCC), 75% EtOH, or chloramphenicol eye drops(Minims<sup>®: 0.5%). Lenses were infected with staphylococcus aureus, staphylococcus epidermidis, or pseudomonas aeruginosa, and then disinfected by; 1)wiping; 2)immersing in disinfectant for 5min; 3)immersing in disinfectant for 10min; n=9. Swab wipes from the lenses were cultured for 24h and colony-forming units were counted to assess bacterial load. Lens clarity was subjectively scored for each method.

    RESULTS: The bacterial load was 1×108/mL ×50μL/lense equals 5×106/lense. Of the three methods the use of 75% EtOH and NaDCC are significantly more effective when used for wiping compared to eye drops(P≤0.01). Wiping with NaDCC or EtOH significantly reduced bacterial load but results were variable and the threat of cross-infection is still present. They were effective if used for 10min, but EtOH adversely affected lens clarity in contrast to NaDCC which had no adverse affects on the lens. Chloramphenicol eye drops were ineffective.

    CONCLUSION: NaDCC immersion for 10min or longer appears to be a simple and effective way to disinfect diagnostic contact lenses during ophthalmic examination.

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王晓蕾,吴燕,陈丽峰,等.眼科诊断用接触镜的消毒现状及消毒效果比较.国际眼科杂志, 2015,15(1):15-19.

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  • 收稿日期:2013-07-09
  • 最后修改日期:2014-11-03
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  • 在线发布日期: 2014-12-30
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