CAJ | 학술논문

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10 min最有效,能完全达到临床消毒要求,氯霉素滴眼液浸泡10 min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10 min 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。
목적：조사국내의원대안과진단용접촉경적소독현상,평고기소독효과。방법：채용방편추양적방법대10소의원진행조사,발현록매소적안액충세、75%을순차식화0.05%적이록이청뇨산납( NaDCC)침포시목전아국림상최상용적안과진단용접촉경소독방법。장피금황색포도구균、표피포도구균혹동록가단포균오염적안과검사용접촉경,용상술삼충소독제안조이하방식진행소독：1)찰식；2)침포소독5min；3)침포소독10min,n=9.연후경면채양,대세균군락배양병계수이평고세균량,관찰소독효과。동시평고소독후경두적청석도。결과：세균부하량위1×108/mL×50μL/경두등우5×106/경두。 NaDCC혹을순소독현저강저료세균량；찰식소독시,75%적을순화NaDCC적소독효과여록매소적안액비교차이현저(P≤0.01),단불능체도림상소독요구,잉연존재교차감염적풍험。침포소독효과여시간정상관,75%적을순화NaDCC침포10 min최유효,능완전체도림상소독요구,록매소적안액침포10 min잉연불능체도림상요구。단을순회영향경두적청석도。결론：NaDCC침포소독10 min 혹경장시간시일충간단유효적안과진단용접촉경소독방법。
?AlM: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? : 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.?CONCLUSlON: NaDCC immersion for 10min or longer appears to be a simple and effective way to disinfect diagnostic contact lenses during ophthalmic examination.