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(P<0.05);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。
OBJECTIVE To discuss the feasibility and safety of conjunctival flap covering combined with cornea ulcer debridement for fungal keratitis,so as to provide a reference for the treatment of fungal keratitis.METHODS A total of 100 cases of patients with fungal keratitis from 2012 to 2016 were collected,and were divided into combination group using conjunctival flap covering combined with cornea ulcer debridement and cornea ulcer debridement group using cornea ulcer debridement,with 50 cases in each group.The fungal infection types,ulcer healing and complications were observed.RESULTS Fungi were cultivated in all patients,which were mainly 63 cases of Fusarium,accounting for 63.00 %.Totally 43 cases were cured in combination group and 34 cases were cured in cornea ulcer debridement group,accounting for 86.00% and 68.00%,and the difference was significant （P〈0.05）.There were 13 cases of complications in combination group and 11 cases of complications in cornea ulcer debridement group,accounting for 26.00% and 22.00%,and there was no significant difference.CONCLUSION The conjunctival flap covering combined with cornea ulcer debridement is an effective treatment method for fungal keratitis,and can improve the cure rate,save the eye compared with the cornea ulcer debridement patients.At the same time,it does not significantly increase the occurrence of postoperative complications,which is safe and reliable.
作者
张坤
侯晓映
周奇鸣
陈桂文
吕云凯
ZHANG Kun HOU Xiao-ying ZHOU Qi-ming CHEN Gui-wen LYU Yun-kai(The Second Hospital of Ningbo, Ningbo, Zhejiang 315010, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第12期2779-2782,共4页
Chinese Journal of Nosocomiology
基金
浙江省自然基金资助项目(LR15H100001)
关键词
结膜瓣遮盖
溃疡清创术
真菌
感染
角膜炎
Conjunctival flap covering
Cornea ulcer debridement
Fungal
Infection
Keratitis
