2004至2011年感染性角膜炎行角膜移植手术的适应证及手术方式变化趋势的研究  

The trends of causes for corneal transplantation indications and surgical methods from 2004 to 2011

作　　者：刘丽梅[1,2,3,4] 史伟云[1,2,3,4] 王婷[1,2,3,4] 高华[1,2,3,4] 

机构地区：[1]山东省医学科学院 [2]济南大学山东省医学科学院医学与生命科学学院 [3]山东省眼科研究所 [4]山东省眼科医院,济南250021

出　　处：《临床眼科杂志》2013年第1期1-4,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81200726);山东省自然科学基金青年基金(ZR2010HQ011)

摘　　要：目的探讨近8年山东省眼科医院感染性角膜炎行角膜移植术的手术适应证和手术方式,并比较前4年与后4年手术适应证及手术方式的变化趋势。方法对2004年1月至2011年12月山东省眼科医院因感染性角膜炎行角膜移植术的患者761例(784只眼)资料进行回顾性调查。结果前4年感染性角膜炎的病因以真菌最为常见,其次为病毒、细菌、棘阿米巴。后4年也以真菌最为常见,其次为细菌、病毒、棘阿米巴。前4年角膜移植手术方式以常规穿透性角膜移植术(PKP)最为常见,其次为常规板层角膜移植术(LKP)、小植片偏中心PKP、深板层角膜移植术(DLKP)。后4年以常规LKP最为常见,其次为常规PKP、小植片偏中心PKP、DLKP。感染性角膜炎角膜移植手术适应证和手术方式的构成比变化在2个时间段差异均有统计学意义。结论真菌性角膜炎在感染性角膜炎患者中居首位,并有上升趋势。常规LKP所占的构成比持续增加,已成为感染性角膜炎首位的手术方式。DLKP及小直径偏中心PKP近几年来明显增加,成为角膜移植手术新的发展趋势。Objective To identify the trends of comes] transplantations performed in Shandong Eye Hospital in the past 8 years. The etiologies and choices of surgical procedures were compared between the first 4-year and the second 4- year. Methods Medical records of 761 infectious kemfifis patients （784 eyes） who received corneal transplantations in Shandong Eye Hospital from January 2004 to December 2011 were reviewed. Results During the first 4-year period, the leading causes for infectious kexatitis that required corneal transplantation, in descending order of frequency, were fungi, herpes simplex virus, bacteria, and acanthamceba. The most common causes during the second 4-year period became fun- gi, bacteria, herpes simplex virus, and aeanthamoeba. Traditional PKP was the leading procedure used in the first 4-year period, followed by traditional LKP, small-diamcter eccentric PKP, and DLKP. In the second 4-year period, traditional LKP became the most commonly chosen procedure, followed by traditional PKP, small-diameter eccentric PKP, and DI^KP. The changes in both the causes and the choices of surgical procedures were significant. Conclusion Fungal kerati- tis is still thc most cermnon cause for keratitis that requires corneal transplantation, and its proportion is continuously ris- ing. Traditional LKP has become the first choice of surgical procedure, while the choice of DLKP or small-diameter eccen- tric PKP also increase significantly in recent years.

关 键 词：角膜移植 回顾性研究 感染性角膜炎 

分 类 号：R779.65[医药卫生—眼科]