角膜移植术后患者再住院的原因分析  

Clinical analysis of re-hospitalization reasons after penetrating keratoplasty

作　　者：文晔[1] 沙翔垠[1] Wen Ye;Sha Xiangyin(Ophthalmic Center,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院眼科中心,广州510260

出　　处：《中华眼外伤职业眼病杂志》2023年第8期600-604,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：广东省自然科学基金(2021A1515010925)。

摘　　要：目的分析穿透性角膜移植术(PKP)患者再住院的原因及其治疗方式。方法横断面研究。纳入广州医科大学附属第二医院2017年1月至2021年12月穿透性角膜移植术的56例(63眼),分析其原发疾病、再住院的直接原因及其治疗方法等。结果原发病因有眼外伤19例(33.93%)、角膜感染12例(21.43%)、角膜白斑9例(16.07%)、角膜内皮失代偿6例(10.71%)、圆锥角膜3例(5.36%)、角膜营养不良5例(8.93%)、免疫性角膜溃疡2例(3.57%)。术后有29例(51.79%)经历再住院治疗,再住院的原因依次为:术后角膜植片排斥10例(34.48%)、原发病复发5例(17.24%)、移植术后感染4例(13.79%)、青光眼3例(10.34%)、角膜植片慢性失功3例(10.34%)、眼球萎缩2例(6.90%)、角膜拆线1例(3.45%)、切口渗漏(低眼压)1例(3.45%)。再住院患者的治疗方式分别为:再次角膜移植术8例(27.59%)、药物治疗14例(48.28%)、抗青光眼手术2例(6.90%)、眼球摘除1例(3.45%)、人工玻璃体植入2例(6.90%)、角膜缝合1例(3.45%)、角膜拆线1例(3.45%)。结论PKP的原发病因以眼外伤和角膜感染为主;角膜移植片排斥为再住院的首位原因,其次是原发病的复发及术后感染;超过半数需再次手术治疗。Objective To analyze reasons of re-hospitalization and treatment methods of re-discharge in patients with penetrating keratoplasty(PKP).Methods This was a cross-sectional study.From Jan.2017 to Dec.2021,63 eyes of 56 patients who underwent PKP in the Second Affiliated Hospital of Guangzhou Medical University were included.Their primary diseases,direct causes of re-admission and treatment methods were analyzed.Results Among the primary causes,19 cases were ocular trauma(33.93%),12 cases were corneal infection(21.43%),9 cases were corneal leucoma(16.07%),6 cases were corneal endothelium decompensation(10.71%),3 cases were keratoconus(5.36%),5 cases were corneal dystrophy(8.93%),and 2 cases were immune corneal ulcer(3.57%).Twenty-nine patients(51.79%)underwent re-hospitalization after operation.The reasons for re-hospitalization were as follows:corneal graft rejection in 10 cases(34.48%),recurrence of primary disease in 5 cases(17.24%),and infection after transplantation in 4 cases(13.79%),glaucoma in 3 cases(10.34%),chronic failure of corneal graft in 3 cases(10.34%),eyeball atrophy in 2 cases(6.90%),corneal suture removal in 1 case(3.45%),and incision leakage(hypotony)in 1 case(3.45%).The treatment methods of re-hospitalized patients were:corneal transplantation in 8 cases(27.59%),drug therapy in 14 cases(48.28%),glaucoma surgery in 2 cases(6.90%),enucleation in 1 case(3.45%),artificial vitreous implantation in 2 cases(6.90%),corneal suture in 1 case(3.45%)and corneal suture removal in 1 case(3.45%).Conclusion The primary causes of PKP are ocular trauma and corneal infections.Rejection after corneal transplantation is the first cause of hospitalization,followed by recurrence of primary disease and postoperative infection.More than half of the re-hospitalized patients need reoperation.

关 键 词：角膜移植术 穿透性 病因 原发 住院 再次 

分 类 号：R779.6[医药卫生—眼科]