结膜瓣掩盖术联合药物治疗真菌性角膜溃疡  

Conjunctival flap covering combined with antifungal medicine for treating refractory fungal corneal ulcer.

作　　者：李晓华[1] 

机构地区：[1]河南南阳医学高等专科学校第一附属医院,河南南阳473058

出　　处：《中华眼外伤职业眼病杂志》2011年第4期295-296,共2页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察结膜瓣掩盖术联合药物治疗难治的真菌性角膜溃疡临床疗效。方法真菌性角膜溃疡26例（26眼），病原体检测明确，角膜溃疡面积直径4～6mm，侵犯深，前房积脓，局部刺激症状明显，局部长期用抗真菌药物难以奏效。先行角膜溃疡面清创，以1％碘酊烧灼溃疡面，然后施行结膜瓣掩盖术，术后加压包扎，进一步进行抗真菌药物治疗。结果23例（23眼）1次手术治愈角膜溃疡。2例术后结膜回退，再次行结膜瓣掩盖加睑缘缝合术。1例穿孔眼内容脱出而行摘除手术。25例通过结膜瓣掩盖术治愈角膜溃疡。结论对于病程长，迁延不愈，溃疡面积大，药物反应差，病情恶化趋势的真菌性角膜溃疡应尽早行结膜瓣掩盖术，可明显提高治愈率。Objective To observe the clinical curative effect of conjunctival flap covering surgery combined with antifungal medicine for treating refractory fungal corneal ulcer. Methods 26 patients （26 eyes ） with refractory fungal corneal ulcer were retrospective analysised. The patients were all pathogen defini- ted, ulcer diameter 4 - 6 mm, hypopyon, local stimulation in evidence, and no effect with topical anti fungal medicine. All the patients were treated with conjunctival flap covering surgery after cauterization with 1% io dine tincture. We made pressure dressings for all the patients, and anti fungal medicine was used for them. Results Postoperatively, the corneal ulcer in 23 eyes was healed. Rollback of conjunctival flaps was ap- peared in 2 cases, which healed after treated again by conjunctival flap covering surgery combined with bleph- arorrhaphy. The content emersion was appeared in 1 case and ocular evisceration was done. The corneal ulcer was cured and the eyeballs were saved in 25 eyes by conjunctival flap covering surgery. Conclusion Con junctival flap covering surgery is effective in treatment for refractory fangal corneal ulcer which has long course of diseases,large ulcer diameter and has not responded to antifungal medicine or even worse.

关 键 词：角膜溃疡 真菌性 结膜瓣掩盖术 

分 类 号：R772.21[医药卫生—眼科] R779.6[医药卫生—临床医学]