角膜清创联合结膜瓣遮盖术治疗真菌性角膜溃疡疗效研究.doc

角膜清创联合结膜瓣遮盖术治疗真菌性角膜溃疡疗效研究 　　doi：10.3969/j.issn.1007-614x.2013.21.46 摘 要 目的：观察角膜清创联合结膜瓣遮盖术治疗真菌性角膜溃疡的临床疗效。方法：收治真菌性角膜溃疡患者40例（40眼），行患眼角膜清创联合结膜瓣遮盖术治疗，术后继续药物治疗。结果：28例28眼1次手术，结膜瓣遮盖良好，角膜溃疡治愈；6例6眼1次手术，1周内结膜瓣脱落或溶解，继续用药10天～2个月角膜溃疡治愈；4例4眼1次手术，1周结膜瓣脱落或溶解，经2次手术，结膜瓣遮盖良好，角膜溃疡治愈；2例2眼1次手术，1周内结膜瓣脱落或溶解，治疗过程中角膜溃疡穿孔，眼内容物脱出，而行眼内容物剜出术。40例40眼通过结膜瓣遮盖总治愈38例38眼，治愈率95%。结论：角膜清创联合结膜瓣遮盖术是一种治疗真菌性角膜溃疡的有效方法，适合基层医院，可以尽可能挽救眼球，保留残存视力，为进一步行角膜移植术提供条件。 关键词 角膜溃疡 真菌 结膜瓣遮盖 Abstract Objective：To study the clinical curative effect of corneal ulcer debridement combined with conjunctiva flap covering surgery in treatment of fungal corneal ulcer.Methods：From January 2008 to December 2012，40cases（40eyes）with fungal corneal ulcer were treated with removal of the necrotic corneal tissue combined with conjunctiva flap covering surgery.Results：Postoperatively，the corneal ulcer in 28 cases（28 eyes）was cured after one surgery，and whose conjunctiva flaps were good；the corneal ulcer 6 cases （6 eyes）was cured by drug in 10 days-2 months afer one surgery，and whose conjunctiva flaps were desquamated in 1 week；the corneal ulcer in 4 cases（4 eyes）was cured afer treated again by conjunctiva flap covering surgery afer the conjunctiva flap covering surgery afer the conjunctiva flap was desquamated in 1 week；the corneal ulcer in 2 eyes was not cured afer one surgery whose conjunctiva flaps were desquamated in 1 week，because of corneal perforation，they had to be performed by the enucleation of eye contents.38 cases （38 eyes） were cured by conjunctiva flap covering surgery in 40 cases（40 eyes），the total effective rate was 95%.Conclusion：Corneal ulcer debridement combined with conjunctiva flap covering surgery is a kind of effective and pratical method in treatment of fungal corneal ulcer.It can be applied in primary hospital，and it is an effective method to control the fungus inflammation and save the eyeballs and remnant vision，which provide the further condition for corneal transportation. Key words corneal ulcer；fungus