自体结膜瓣移植手术治疗重症真菌性角膜溃疡的临床价值

Value of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer

摘要:

目的：探讨自体结膜瓣移植手术治疗重症真菌性角膜溃疡的效果。

方法：选取2013-01/2016-01在我院治疗的重症真菌性角膜溃疡患者83例83眼，其中接受药物治疗患者36例36眼，接受自体结膜瓣移植手术治疗患者47例47眼，两组进行真菌培养及菌属鉴定，观察两组治疗的效果。

结果：手术治疗组有效率为89%，明显高于药物治疗组，差异比较有统计学意义(P<0.05)； 丝状菌类型手术治疗的有效率为92%，明显高于药物治疗，差异比较有统计学意义(P<0.05)； 酵母菌类型手术治疗和药物治疗的有效率分别为80%、78%，差异比较无统计学意义(P>0.05)。

结论：自体结膜瓣移植手术治疗重症真菌性角膜溃疡的疗效好，且操作简单； 对药物治疗不佳的丝状菌型角膜溃疡，应及时进行手术治疗以提高疗效。

Abstract:

AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer.

METHODS: A total of 83 cases(83 eyes)with severe fungal corneal ulcer treated in our hospital from Jan.2013 to Jan.2016 were selected. Among them, 36 cases(36 eyes)were treated with drug therapy, and 47 patients(47 eyes)were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.

RESULTS: The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant(P<0.05); The effective rate of surgical treatment of filamentous bacteria was 92%, which was significantly higher than that of drug treatment, the difference was statistically significant(P<0.05). The effective rates of surgical treatment and drug treatment of yeast were 80% and 78%, the difference was not statistically significant(P<0.05).

CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.