青岛某医院穿透性角膜移植手术原因

目的:分析过去10余年穿透性角膜移植术(PKP)的手术原因及变化情况。方法:回顾性系列病例研究。收集2013年1月至2017年12月在青岛眼科医院接受PKP的所有患者的病历资料,并与2005-2010年在青岛眼科医院接受PKP患者的资料进行比较,分析其年龄、性别和接受PKP相关的临床诊断等资料。采用卡方检验对2个时间段的PKP的手术原因进行统计分析。结果:2013-2017年间,共行PKP855例,前4位的手术原因依次为化脓性角膜炎303例(35.4%)、再次角膜移植132例(15.4%)、圆锥角膜130例(15.2%)和病毒性角膜炎115例(13.5%)。2005-2010年间,共行PKP875例,前4位手术原因依次为化脓性角膜炎、病毒性角膜炎、圆锥角膜和大泡性角膜病变。2个时间段内,PKP的主要手术原因均为化脓性角膜炎,其所占比例无明显变化(χ^2=0.543,P=0.461)。再次角膜移植的比例增加,成为青岛眼科医院2013-2017年间PKP第2位的手术原因(χ^2=33.294,P<0.001)。圆锥角膜始终居于PKP手术原因的第3位,但2013-2017年间PKP手术原因中所占比例较2005-2010年增加(χ^2=6.061,P=0.014)。病毒性角膜炎的比例下降,从2005-2010年的第2位下降到2013-2017年第4位的手术原因(χ^2=6.397,P=0.011)。结论:化脓性角膜炎是2013-2017年青岛眼科医院PKP的首位手术原因,然后依次为再次角膜移植、圆锥角膜和病毒性角膜炎。与2005-2010年相比,2013-2017年青岛眼科医院因再次角膜移植与圆锥角膜行PKP的比例上升,而病毒性角膜炎的比例下降。

Analysis of Causes for Penetrating Keratoplasty in a Hospital in Qingdao

Objective: To analyze the causes and identify trends of penetrating keratoplasty (PKP) over the past 10 years. Methods: This was a retrospective case series study. Medical records of patients who underwentPKP at Qingdao Eye Hospital from January 2013 to December 2017 were collected, and the data was compared to that from the 2005 to 2010 period at the same hospital. Data of patients, including age, sex, and preoperative primary diagnosis for PKP were reviewed. The proportion of the different causes for PKP during 2005-2010 and 2013-2017 was statistically analyzed with a Chi-square test. Results: PKPs were performed on 855 cases from 2013 to 2017. The top four causes were suppurative keratitis (303 cases, 35.4%), regraft (132 cases, 15.4%), keratoconus (130 cases, 15.2%), and herpes keratitis (115 cases, 13.5%). PKPs were performed on 875 cases from 2005 to 2010. The top four causes for PKP were suppurative keratitis, herpes keratitis, keratoconus, and bullous keratopathy. Suppurative keratitis was the first causes for PKP during both periods in 2005-2010 and 2013-2017, and the proportion of the causes for PKP was not significantly different (χ2 =0.543, P=0.461). Regraft increased as the second causes for PKP during 2013 to 2017 (χ2 =33.294, P<0.001). Keratoconus remained in third place, but the proportion of PKP increased from 2013-2017 compared to 2005-2010 (χ2 =6.061, P=0.014). The proportion of herpes keratitis decreased from the second causes during 2005-2010 to the fourth causes during 2013-2017 (χ2 =6.397, P=0.011). Conclusion: Suppurative keratitis was the leading causes of PKP at Qingdao Eye Hospital from 2013 to 2017, followed by regraft, keratoconus and herpes keratitis. Compared to 2005-2010, the proportions of regraft and keratoconus increased significantly in 2013-2017 at Qingdao Eye Hospital, while the proportion of herpes keratitis decreased.