论文部分内容阅读
目的 观察无环鸟苷对HSV 1角膜炎的治疗和预防复发作用。方法 选用 1 0 5例HSV角膜炎病人 ,将病人按临床表现分为 4组 ,即上皮型、基质型、坏死型及HSV角膜炎行角膜移植及结膜瓣遮盖术 ,并对 4组病人选用全身 +局部无环鸟苷治疗。愈后将上皮质型和基质型患者随机分为2组 ,抗复发治疗组和对照组。治疗组给予口服预防量无环鸟苷 3 0 0mg/d ,持续一年。对照组未给予任何药物。结果 上皮型经口服及局部点眼后 96%痊愈。基质型给予口服加局部无环鸟苷点眼 ,同时给予激素滴眼治愈率为 1 0 0 %。坏死型经 1 0 0 0mg/d无环鸟苷静脉应用 ,治愈率达 3 3 % ,余穿孔行结膜瓣遮盖及角膜移植术 ,术后静脉应用无环鸟苷 2周尽快控制病情 ,角膜植片及结膜与伤口愈合。上皮质型和基质型的角膜炎治愈后持续应用无环鸟苷口服 3 0 0mg/d ,随访 1年 ,治疗组有 5例复发 ,对照组有 1 4例复发 ,两组比较有显著的统计学差 (P <0 0 1 )。结论 无环鸟苷局部 +全身治疗对HSV角膜炎有较好的治疗作用 ,低剂量长期口服对控制复发有良好的作用。随访期间未见全身及局部副作用
Objective To observe the effect of acyclovir on the treatment and prevention of HSV 1 keratitis. Methods One hundred and fifty cases of HSV keratitis were selected. The patients were divided into 4 groups according to clinical manifestations: epithelial, stromal, necrotic and HSV corneal keratoplasty and conjunctival flap masking. Four groups of patients were selected with whole body + Acyclovir treatment. The more patients with epithelial-type and stromal type were randomly divided into 2 groups, anti-relapse treatment group and control group. The treatment group was given oral preventive acyclovir 300 mg / d for one year. The control group did not receive any drugs. The results of epithelial oral and local eye after 96% recovered. Stromal type given oral acyclovir plus point, while giving hormone eye drops cure rate was 100%. The necrotic model was treated with 100 mg / d acyclovir intravenously and the cure rate was 33%. The remaining perforation was covered by conjunctival flap and corneal transplantation. The application of acyclovir intravenously after 2 weeks was controlled as soon as possible. The corneal graft Film and conjunctiva and wound healing. After the cure of epithelial type and stroma keratitis, continuous administration of acyclovir 300 000 mg / d, followed up for 1 year, the treatment group 5 cases of recurrence, the control group 14 cases of recurrence, the two groups were statistically significant Poor learning (P <0.01). Conclusion Acyclovir local + systemic treatment of HSV keratitis have a better therapeutic effect, low-dose long-term oral control of recurrence has a good effect. No systemic and local side effects during follow-up