真菌及阿米巴混合感染性角膜炎临床分析  

Clinical analysis of combined fungal and acanthamoeba keratitis

作　　者：胡建章[1] 许建斌[1] 黄礼彬[1] 朱学军[1] 韩晓丽[1] 徐国兴[1] 

机构地区：[1]福建医科大学附属第一医院眼科福建省眼科研究所,福州350005

出　　处：《中国实用眼科杂志》2010年第2期162-164,共3页Chinese Journal of Practical Ophthalmology

基　　金：福建省科技厅青年人才项目（2008F3041）,福建医科大学教授发展基金（2006-js6033）,福建省卫生厅青年科研基金（2007-2-1;2008-2-18）

摘　　要：目的探讨真菌及棘阿米巴混合感染性角膜炎的发病、临床特征、诊断及其治疗。方法对2007年7月至2008年12月在福建医科大学附属第一医院确诊的19例真菌及棘阿米巴混合感染性角膜炎进行回顾性临床分析，分析其发病诱因、诊断方法及临床特征，采用抗真菌及阿米巴药物或结膜瓣遮盖术或穿透性角膜移植术进行治疗并观察疗效。结果19例确诊病例中，14例发病与角膜外伤有关，3例与角膜接触镜相关；所有病例通过角膜刮片镜检，或真菌与阿米巴培养确诊；16例表现为角膜局部溃疡型，3例表现为基质环形浸润；5例经药物治愈，11例经结膜瓣遮盖治愈，2例行穿透性角膜移植术（PKP）。结论真菌及棘阿米巴混合感染性角膜炎的发病诱因以角膜外伤为主，角膜刮片镜检是早期诊断的有效方法，综合药物和手术治疗对感染的控制具有重要意义。Objective To study the etiology, clinical features, diagnosis and treatment of patients with combined fungal and acanthamoeba keratitis.Methods Nineteen cases of combined fungal and acanthamoeba keratitis at the First Affiliated Hospital of Fujian Medical University between July 2007 and May 2008 were retrospectively reviewed.Predisposing factors, diagnosis, and clinical characteristics of the patients were analyzed. The patients were received medications or conjunctival flap coveting or penetrating keratoplasty （PKP）.Resuits Patients in this series, risk factors included corneal trauma （ 14/19 ） and contact lens wear （3/19）.Patients were confirmed by corneal scraping and microscopic examination, and/or fungal/amoeba culture.Sixteen cases were showed cornea/local ulcer, and 3 cases were ring-shaped stromal infiltration. Five cases were cured by combined anti-amoeba and anti-fungal drug therapy, and 11 patients were healed by conjunctival flap covering, and 2 patients performed PKP.Conclusinns The main risk factor of combined fungal and acanthamoeba keratitis is corneal trauma.Scraping and microscopic examination is an effective method for early diagnosis.Anti-amoeba/fungal drug therapy combined with conjunctival flap covering is an effective method to treat this keratitis.

关 键 词：角膜炎 棘阿米巴 真菌 混合感染 

分 类 号：R772.21[医药卫生—眼科]