冷冻联合羊膜移植治疗镰孢菌属真菌性角膜溃疡
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Clinical observation of cryotherapy and amniotic membrane transplantation in the management of Fusarium corneal ulcer
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    摘要:

    目的:探讨冷冻治疗镰孢菌属真菌性角膜溃疡的安全性和有效性。

    方法:回顾性系列病例研究。对2010-01/2013-05于我院手术治疗的经真菌培养阳性,并鉴定菌种为镰孢菌属的真菌性角膜溃疡住院患者41例41眼进行回顾性分析。所有患者均行病灶切除联合羊膜移植术,其中冷冻组22例22眼,无冷冻组19例19眼,术后随访时间3~12mo,分析对比术后疗效、角膜溃疡愈合时间、视力、角膜新生血管化程度、并发症及复发情况。

    结果:冷冻组总有效率明显优于无冷冻组(P<0.05),但在治愈率及好转率上与无冷冻组差异无统计学意义(P>0.05)。两组术后视力均较术前有所提高且差异有统计学意义(P<0.05),但两组术后视力对比差异无统计学意义(P>0.05),角膜病灶区遗留不同程度角膜瘢痕。冷冻组的角膜溃疡愈合时间比无冷冻组显著缩短(P<0.05)。冷冻组无并发症发生,无冷冻组1例发生继发性青光眼。

    结论:冷冻治疗镰孢菌属真菌性角膜溃疡是安全有效的辅助方法。

    Abstract:

    AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer.

    METHODS: Retrospective contract analysis of the clinical data of 41 patients(41 eyes)who infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases(22 eyes), non-cryotherapy group of 19 cases(19 eyes). All the cases were followed up for 3~12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences.

    RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity(P>0.05). The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non-cryotherapy group(P<0.05). The postoperative visual acuity of two group were higher than that of preoperatively(P<0.05). There was no complication occurred in cryotherapy group while there was 1 patient of secondary glaucoma in non-cryotherapy group.

    CONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

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谢琼,高明宏,禹海.冷冻联合羊膜移植治疗镰孢菌属真菌性角膜溃疡.国际眼科杂志, 2014,14(10):1783-1785.

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  • 收稿日期:2014-05-16
  • 最后修改日期:2014-09-04
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  • 在线发布日期: 2014-09-22
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