65例化脓性角膜溃疡临床分析  

Analysis of the Pyogenic Corneal Ulcer in 65 Cases

作　　者：熊洁[1] 邓应平[1] 王琳[1] 

机构地区：[1]四川大学华西医院眼科,四川成都610041

出　　处：《华西医学》2006年第2期301-302,共2页West China Medical Journal

摘　　要：目的研究分析化脓性角膜溃疡的诱因、病原体及预后等临床特点,为临床诊断、治疗提供更有效依据。方法对1997年到2004年于我院眼科住院的、诊断明确的65例化脓性角膜溃疡病例进行回顾性分析。结果在65例角膜溃疡中,有24例(36.9%)诱因不明,18例(27.7%)为外伤引起,17例(26.2%)因配戴角膜接触镜引起,还有6例由继发感染造成。通过对其中60例的微生物涂片及培养,34例得到了阳性结果(阳性率56.7%),其中12例细菌培养阳性,以表皮葡萄球菌(4例,33.3%)和绿脓杆菌(4例,33.3%)为主;14例真菌培养阳性,以镰刀菌(12例,85.7%)和曲霉菌(2例,14.3%)为主;涂片发现4例棘阿米巴;此外有4例培养发现为细菌和真菌混合感染,针对病原体给以敏感抗生素联合药物治疗32例(49.2%),行角膜移植19例(29.2%),结膜瓣遮盖5例(7.6%),9例(13.8%)行眼内容物剜除术,治愈51例(治愈率78.5%),4例好转(6.2%),10例无效(15.4%)。结论化脓性角膜溃疡危害极大,应重在预防。及时的病原学检查、合理使用有效的治疗手段对于挽救患者的视功能是非常重要的。Objectivc： To investigate the cause, the pathogen and the prognosis of pyogenic corneal ulcer according to which we could make appropriate treatment project. Methods： 65 eases of pyogenic corneal ulcer were analysised with the cause, pathogen, therapy and prognosis, all of which were definitely diagnosed and admitted to authors＇ hospital during 1997 to 2004. Results： Among 65 cases, there were 24 cases （36.9%） found no obvious causes, 18 cases （27.7%） caused by trauma, 17 cases （26.2%） by contact lenses and 6 cases （9.2%） by secondary infection. In 60 cultured specimens, 34 cases （56.7%） were detected positive. Bacteria was found in 12 vcases （20.0%）, fungus in 14v cases （23.3%） and acanthamoeba in 4 cases （6.7%）, moreover, both bacteria and flmgus was found in 4 cases （6.7%）. The major pathogen of bacteria was staphylococcus epidennidis （4 cases, 33.3%） and pseudomonas aeruginosa （4 cases, 33.3%）, major pathogen of fungus was fusarium （12 cases, 85.7%） and aspergillus （2 cases, 14.3%）. With the appropriate therapy, 51 （78. 5%） cases were cured. Conclusion： More attention should be paid to prevention of pyogenic corneal ulcer. For ophthahnologists, the most important thing is to diagnosing and treating the disease earlier.

关 键 词：角膜溃疡 细菌 真菌 棘阿米巴 

分 类 号：R772.21[医药卫生—眼科]