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目的分析化脓性角膜炎病因、病原、临床特点及预后。方法对1999年1月至2008年8月在本科住院治疗、诊断明确的241例化脓性角膜炎患者进行回顾性分析。结果外伤是最主要的危险因素(39.4%),病原检出阳性率为46.7%,其中细菌占30.2%,真菌占12.3%,混合感染4.2%。在前房积脓和角膜穿孔的病例中,检出的病原以真菌居多,病灶直径>6mm或前房积脓>1mm的病例预后差。246眼中手术治疗66眼,非手术治疗148眼,眼球摘除术32眼,出院时治愈151眼。结论化脓性角膜炎是危害极大的致盲性眼病,细菌仍是主要致病菌,其预后与临床体征及病原种类有关,及早诊治和手术干预仍是挽救眼球的有力措施。
Objective To analyze the etiology, pathogenesis, clinical features and prognosis of suppurative keratitis. Methods A retrospective analysis of 241 patients with suppurative keratitis treated in our hospital from January 1999 to August 2008 was conducted. Results Trauma was the most important risk factor (39.4%). The positive rate of pathogen detection was 46.7%. Bacteria accounted for 30.2%, fungi accounted for 12.3% and mixed infection was 4.2%. In the cases of empyema and perforation of the anterior chamber, the majority of the pathogens detected were fungi, with a poor prognosis in patients with lesions of> 6 mm in diameter or empyema> 1 mm. There were 66 eyes surgically treated in 246 eyes, 148 eyes treated non-surgically, 32 eyes enucleated, 151 eyes were cured at discharge. Conclusions Suppurative keratitis is a potentially devastating blinding eye disease. Bacteria are still the main pathogenic bacteria. The prognosis is related to clinical signs and pathogenic species. Early diagnosis and surgical intervention are still powerful measures to save the eyeball.