中浅层真菌性角膜炎治疗方式选择分析  

Primary study of treatment methods, of superficial fungal keratitis

作　　者：姜剑[1] 毕宏生[1] 王兴荣[1] 温莹[1] 张建华[1] 

机构地区：[1]山东中医药大学附属眼科医院,济南250002

出　　处：《中国实用眼科杂志》2012年第4期455-457,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析研究药物保守治疗、羊膜移植和板层角膜移植（lamellar keratoplasty，LKP）在中浅层真菌性角膜炎治疗中效果。方法对2008年1月至2009年12月就诊的中浅层真菌性角膜炎病人应用裂隙灯观察感染累及角膜组织的中浅层，未累及角膜全层的35例患者。角膜刮片或角膜病理切片，两者中有一项查见菌丝者确诊为真菌性角膜炎。给予全身局部抗真菌治疗。局部2。3d角膜溃疡清创一次，碘酊烧灼5s钟后生理盐水冲洗。病情迁延不愈的患者，在局麻下行角膜清创，如病灶累及角膜厚度1／3以内，行羊膜移植术；如感染灶累及角膜厚度1／3以上且未累及角膜全层，行LKP术。结果9例患者通过药物保守治疗后治愈。17例患者行角膜清创联合羊膜移植术治疗，其中16例治愈，1例复发后行LKP术治愈。10例患者行LKP术治愈（包括羊膜移植术后复发的1例患者）。结论药物治疗可以有效治愈部分中浅层真菌性角膜炎，对于药物保守治疗持续不愈的患者可以选择羊膜移植和LKP术治疗。Objective To evaluate the efficiency of drug, amniotic membrane transplantation and lamellar keratoplasty for superficial fungal keratitis. Methods Drug, amniotic membrane transplantation and lamellar keratoplasty was applied to 35 cases of superficial fungal keratitis in our hospital from January 2008 to December 2009. Results Nine cases of fungal keratitis were cured by drug. Amniotic membrane transplantation was performed in 17 cases of fimgal keratitis, 16 cases were cured and fungal keratitis recurred on 1 case. Ten cases were performed lamellar ,keratoplasty. Conclusions Fungal keratitis can be cured by drug, amniotic membrane transplantation and lamellar keratoplasty. Amniotic membrane transplantation or lamellar keratoplasty will be an effective method for fungal keratitis if medical therapy failed.

关 键 词：角膜炎 真菌 药物 羊膜 板层角膜移植 

分 类 号：R772.21[医药卫生—眼科]