结膜瓣遮盖联合溃疡清创治疗真菌感染性角膜炎的可行性及安全性分析

发布时间：2018-01-24 09:08

本文关键词： 结膜瓣遮盖溃疡清创术真菌感染角膜炎　出处：《中华医院感染学杂志》2017年12期 　论文类型：期刊论文

【摘要】：目的探讨结膜瓣遮盖联合溃疡清创治疗真菌感染性角膜炎的可行性及安全性,为真菌感染性角膜炎的治疗提供参考依据。方法收集2012-2016年真菌感染性角膜炎患者100例,行结膜瓣遮盖联合溃疡清创术治疗为联合治疗组,单纯溃疡清创术治疗为溃疡清创组,各50例;分别行溃疡清创术、溃疡清创后行结膜瓣遮盖术治疗,观察感染真菌类型、溃疡愈合情况、并发症发生情况。结果患者均培养出真菌,以镰刀菌属感染为主,共63株占63.00%;联合治疗组溃疡治愈43例,治愈率为86.00%,溃疡清创组溃疡治愈34例,治愈率为68.00%,差异有统计学意义(P0.05);联合治疗组术后13例发生并发症,发生率为26.00%,溃疡清创组术后11例发生并发症,发生率为22.00%,差异无统计学意义。结论结膜瓣遮盖联合溃疡清创治疗真菌感染性角膜炎是一种有效的治疗方法,相对于单纯溃疡清创患者能提高治愈率,挽救眼球,同时未显著增加术后并发症的发生,相对安全可靠。
[Abstract]:Objective to investigate the feasibility and safety of conjunctival flap covering combined with ulcer debridement in the treatment of fungal infectious keratitis. Methods 100 cases of fungal keratitis from 2012 to 2016 were collected and treated with conjunctival flap covering combined with ulcer debridement. Simple ulcer debridement was treated by ulcer debridement group (50 cases each). Ulcer debridement and conjunctival flap covering after ulcer debridement were performed to observe the types of infected fungi, ulcer healing and complications. Results all the patients cultured fungi, mainly Fusarium infection. 63 strains accounted for 63.00; In the combined treatment group, the ulcer was cured in 43 cases, the cure rate was 86.00. In the ulcer debridement group, 34 cases were cured and the cure rate was 68.00. The difference was statistically significant (P 0.05). Complications occurred in 13 cases (26.00%) in the combined treatment group and in 11 cases (22.00% cases) in the ulcer debridement group. Conclusion conjunctival flap combined with ulcer debridement is an effective method to treat fungal infectious keratitis. Compared with simple ulcer debridement patients can improve the cure rate and save the eyeball. At the same time, the incidence of postoperative complications was not significantly increased, relatively safe and reliable.
【作者单位】：宁波市第二医院眼科;
【基金】：浙江省自然基金资助项目(LR15H100001)
【分类号】：R779.6
【正文快照】： 真菌感染性角膜炎是一种严重的化脓性眼部疾病,也是致盲的疾病之一,由于角膜接触镜的佩戴人次增加及抗菌药物的不规范使用、糖皮质激素在眼部的过量使用等原因,真菌感染性角膜炎发病率在临床上有逐年升高趋势[1-3],在临床上化脓性角膜炎中真菌感染性角膜炎约占50.00%,已经成为

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