抗真菌药物联合结膜瓣覆盖治疗重度真菌性角膜溃疡  

Therapeutic alliance of anti-fungal agents and conjunctival flap surgery on severe fungal corneal ulcer

作　　者：郭斌[1,2] 范钦华[1] 杨新光[2] 陈倩[1] 刘钊[3] 杨建东[1] 曹丽[1] 

机构地区：[1]中国人民解放军81医院眼科,中国江苏省南京市210002 [2]中国陕西省西安市第四医院眼科,710004 [3]西安交通大学医学院,中国陕西省西安市710061

出　　处：《国际眼科杂志》2009年第6期1155-1156,共2页International Eye Science

摘　　要：目的:观察抗真菌药物联合结膜瓣覆盖治疗重度真菌性角膜溃疡的临床效果。方法:对重症真菌性角膜溃疡患者19例19眼进行抗真菌药物联合结膜瓣覆盖治疗,其中使用的抗真菌药物包括氟康唑、大蒜素、那他霉素眼液、斯皮仁诺等,观察治疗前后角膜刺激症状、视力、角膜溃疡愈合等变化。结果:术后角膜刺激症状明显减轻,治疗1mo后17眼结膜伤口愈合,视力:光感～0.3。另2眼复发加重,其中1例放弃治疗,因穿孔发生眼内炎,选择眼球摘除1例。术后1a,6例患者打开结膜瓣,角膜上皮平复,角膜白斑4例和斑翳2例。结论:抗真菌药物联合结膜瓣覆盖是一种有效的重度真菌性角膜溃疡治疗方案。AIM： To observe the clinical outcomes of the therapeutic alliance of anti-fungal agents and conjunctival flap surgery on severe fungal corneal ulcer. METHODS： Nineteen cases （19 eyes） with severe fungal corneal ulcer were treated with the therapeutic alliance of anti-fungal agents and conjunctival flap surgery. The anti-fungal agents included fluconazole, allitricin, natamycin, sporanox, et al . The changes of corneal irritation, visual acuity and ulcer area were observed before and after the treatment. RESULTS： The corneal irritation in all patients alleviated obviously after the treatment. Conjunctival incision of 17 cases healed completely 1 month after surgery and the visual acuity were light perception to 0.3. There were 2 eyes with recurrence and aggravation of corneal ulcer, and one abandoned further treatment, the other chose ophthalmectomy because of endophthalmitis after corneal perforation. One year after surgery, 6 cases conjunctival flap covers were opened and corneal epithelium returned to normal, in which 4 cases had corneal leucoma and the other 2 cases had corneal macula. CONCLUSION： The therapeutic alliance of anti-fungal agents and conjunctival flap surgery may be an effective therapeutic schedule on severe fungal corneal ulcer.

关 键 词：真菌性角膜溃疡 抗真菌药物 结膜瓣覆盖 

分 类 号：R779.6[医药卫生—眼科]