角膜溃疡清创术联合抗真菌药物治疗真菌性角膜炎

目的:总结角膜溃疡清创术联合抗真菌药物治疗真菌性角膜炎的效果。方法:收集2010-09/2011-09在我院就诊的真菌性角膜炎患者30例,对患者进行常规角膜刮片检查,并对全部患者施行角膜溃疡清创术,根据角膜炎的严重程度联合给予氟康唑或那他霉素眼水点眼治疗,清创术治疗无效者采用自体结膜覆盖术及板层角膜移植术治疗,随访观察治疗效果。结果:角膜刮片阳性结果 27例,阳性率90%,2例于外院行共聚焦显微镜检查菌丝阳性;1例为明确植物外伤史的8岁儿童,不能配合真菌检查。轻度角膜炎6例,施行角膜溃疡清创术联合氟康唑眼水点眼治疗全部痊愈,病程2～3wk;中度度角膜炎17例,行角膜溃疡清创术联合那他霉素眼水点眼治疗痊愈12例,病程4～8wk;重度角膜炎7例,行角膜溃疡清创术联合那他霉素眼水点眼治疗痊愈3例,病程8～10wk。角膜溃疡清创术联合抗真菌药物治疗真菌性角膜炎有效率70%。结论:角膜溃疡清创术联合抗真菌药物治疗真菌性角膜炎操作简单,是一种经济、有效、可行的治疗方式。

Effect of corneal ulcer debridement combined with antimycotic drug for fungal keratitis

AIM:To analyze the effect of corneal ulcer debridement combined with antimycotic drug for fungal keratitis·METHODS:Collecting 2010-09/ 2011-09 fungal keratitis 30 cases in our hospital,all patients were treated with corneal scraping,followed with corneal ulcer debridement,and fluconazole or natamycin eyedrop according to the severity of keratitis,ineffective treatment cases resorted to the self conjunctiva cover or lamellar kemtoplasty.The therapetic results were observed with following up·RESULTS:Totally 27 cases corneal blade and fungi culture were positive,positive rate were 90%.Among these cases,6 mild keratitis cases all recovered after corneal ulcer debridement combined with fluconazole eyedrop,course 2-3weeks.The moderate keratitis were 17 cases,12 cases recovered after corneal ulcer debridement combined with natamycin eyedrop,course 4-10weeks.7 cases became serious,among which 3 cases underwent self conjunctiva cover,1 cases underwent the lamellar kemtoplasty.The total effective rate of corneal ulcer debridement combining with antimycotic drug for fungal keratitis was 70%·CONCLUSION:Corneal ulceration debridement combined with antimycotic drug is simple,economic,effective and feasible treatment for fungal keratitis.