论著

中国南方与西北地区慢性泪囊炎细菌谱的差异

Comparative analysis of the bacterial spectrum in chronic dacryocystitis between Northern and Southern China

:12-19
 
目的:比较中国南方地区与西北地区慢性泪囊炎患者的菌群分布,明确细菌谱的地理差异性,对不同地区抗生素使用因地制宜提供依据。方法:本研究为回顾性横断面研究。纳入2022年3月—2024年4月在中国西北地区三甲医院眼科诊断为慢性泪囊炎,拟行泪囊鼻腔吻合术的患者,并选取同时期在中国南方地区诊断为慢性泪囊炎的患者,所有患者在行经鼻镜泪囊鼻腔吻合术时切开泪囊取泪囊分泌物。两组标本均行一般细菌及真菌培养,比较两组细菌培养阳性率和构成比。结果:南方地区和西北地区泪囊分泌物细菌培养阳性率分别为26.0%和50.7%,差异有统计学意义(P < 0.001)。南方地区细菌分布中革兰阳性球菌、革兰阴性杆菌的构成比分别为 45.9%、37.6%,西北地区两种菌构成比为 71.4%、19.0%,差异有统计学意义(分别为P = 0.007,P = 0.003)。两地区检出率最高的菌均为凝固酶阴性葡萄球菌,链球菌属占比在两地区间比较差异有统计学意义(P = 0.004)。结论:中国南方地区比西北地区泪囊分泌物培养阳性率低,慢性泪囊炎细菌谱均以革兰阳性菌为主,南方地区革兰阴性菌占比较西北地区更高,链球菌属检出率较西北地区明显更低。这可能是不同地理环境、不同气候、不同生活习惯等共同因素的结果。
Objective: To compare the bacterial distribution of patients with chronic dacryocystitis from southern China and northwest China and to elucidate the geographical differences in the bacterial spectrum. Methods: This retrospective cross-sectional study included patients diagnosed with chronic dacryocystitis at the ophthalmology departments of tertiary hospitals in southern and northwest China between March 2022 and April 2024. Endoscopic dacryocystorhinostomy was performed on all patients to collect lacrimal sac secretions. The specimens were cultured for bacteria and fungi, and the positive rates and composition ratios of bacterial culture were compared between the two groups. Results: The positive rates of bacterial cultures from lacrimal sac secretions were 26.0% in southern China and 50.7% in northwest China (P < 0.001). The proportions of Gram-positive cocci and Gram-negative bacilli were 45.9% and 37.6%, respectively, in southern China, compared to 71.4% and 19.0%, respectively, in northwest China (P = 0.007 and P = 0.003, respectively). Coagulase-negative staphylococci were the most frequently detected bacteria in both regions. However, the proportion of Streptococcus species was significantly higher in northwest China compared to southern China (P = 0.004). Conclusions: The positive rate of lacrimal sac secretion cultures was lower in southern China compared to northwest China. The bacterial spectrum of chronic dacryocystitis in both regions was predominantly composed of Gram-positive bacteria. However, the proportion of Gram-negative bacteria was higher in southern China, while the detection rate of Streptococcus species was significantly higher in northwest China. These differences may be attributed to variations in climate, geographical features, and lifestyle habits.
论著

黏膜瓣泪小点成形术治疗慢性泪小管炎的疗效

Efficacy of mucosal flap punctoplasty in the treatment of chronic canaliculitis

:881-887
 
目的:观察黏膜瓣泪小点成形术用于治疗慢性泪小管炎的疗效。方法:回顾性病例系列研究。收集2018年1月至2020年12月中山眼科中心眼整形科就诊的44例慢性泪小管炎患者的临床资料,分析其性别、年龄、患病眼别、临床症状、泪道冲洗结果等临床特点。采用黏膜瓣泪小点成形术进行治疗,术后随访评估其疗效。结果:44例慢性泪小管炎患者以女性为主(男女比例1:3.9),单侧发病,多累及下泪小管(上下泪小管比例1:3),主要表现为分泌物增多、溢泪以及内眦部位红肿,结石阳性率为95.7%,病原微生物检查结果显示以放线菌感染为主(78.3%)。大部分患者术后1周内症状得到明显改善,其中1例上下泪小管炎患者于术后2个月出现上泪小管炎复发。总体治愈率为97.8%,随访时间为(20.7±10.9)个月。结论:黏膜瓣泪小点成形术治疗慢性泪小管炎的临床疗效确切,方法可靠。
Objective: To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis. Methods: In this retrospective serial case study, the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020. Demographic data such as gender, age, affected eye, clinical presentations and lacrimal duct irrigation results were analyzed. The efficacy of the procedure, symptom resolution and complications were assessed. Results: Of the 44 patients, most (male:female 1:3.9) were female, and the disease most often (upper:lower 1:3) involved the lower lacrimal canaliculus of only one eye. Main symptoms included increased secretion, tearing, and swelling of the inner canthus. Stones were present in 95.7% of patients and Actinomyces israelli was found to be the most common pathogen (78.3%). Most patients’ symptoms improved significantly within 1 week after surgery. Only one patient, who had infections in both the upper and lower canaliculi, had recurrence of upper canaliculitis 2 months after the surgery. The overall cure rate was 97.8%, and the follow-up time was (20.7±10.9) months. Conclusion: Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.
论著

氦氖激光治疗喀什地区儿童弱视的随机对照研究

氦氖激光治疗喀什地区儿童弱视的随机对照研究

:2-7
 
目的:通过随机对照试验,观察氦氖激光在喀什地区弱视儿童中的治疗效果。方法:选取2016年2月至2018年11月期间就诊喀什地区第一人民医院符合纳排标准的弱视儿童,按随机数字表法,分为试验组(氦氖激光+弱视常规治疗组)与对照组(弱视常规治疗组),比较两组的弱视治疗效果。结果:本试验成功纳入弱视儿童111例(177眼),其中试验组61例(97眼),对照组50例(80眼)。与对照组相比,汉族试验组弱视儿童效果明显(P=0.023),维吾尔族试验组弱视儿童未见明显疗效(P=0.481);试验组与对照组在喀什地区不同年龄、不同弱视程度、不同弱视类型及不同弱视眼数儿童中未见明显差异(P>0.05)。结论:氦氖激光治疗喀什地区弱视儿童作用有限,为避免过度医疗,不建议在南疆地区开展。
Objective: To observe the therapeutic effect of helium-neon laser in amblyopia children in Kashgar by a randomized controlled trial. Methods: Amblyopia children who met eligibility criteria during February 2016 to November 2018 were selected and divided into two groups according to random number table: test group(helium-neon laser + conventional treatment for amblyopia) and control group (conventional treatment for amblyopia). The effects of amblyopia treatment were compared between two groups. Results: One hundred and eleven amblyopic children (177 eyes), including 61 children (97 eyes) of the test group and 50 children (80 eyes) of the control group were included in this study. The effect of helium-neon laser was significant in Han children (P=0.023), but not in Uygur children (P=0.481) in the test group compared with the control group.Conclusion: Helium-neon laser has limited effect in treating children with amblyopia in Kashgar region. To avoid over-treatment, it is not recommended to perform it in southern Xinjiang.

其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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