CAJ | 학술논문

目的分析非外伤性角膜穿孔的原发病,为积极治疗原发病预防角膜穿孔的发生提供帮助.方法 ,对山东省眼科研究所1997年1月至2007年6月间377例非外伤性角膜穿孔住院患者(383只眼)的病历资料进行回顾性分析,观察角膜穿孔的原发病.结果感染性角膜病是导致角膜穿孔最多见的原发病.其中,单纯疱疹病毒性角膜炎(herpes simplex keratitis,HSK)最多(145例,37.9%),其次为真菌性角膜炎(95例,24.8%),再次为细菌性角膜炎(52例,13.6%).8只眼发生2次角膜穿孔,原发病分别为HSK(4例)、Mooren溃疡(2例)、坏死性角巩膜炎与细菌性角膜炎各1例.33只眼为角膜移植术后植片穿孔,植片穿孔的原因依次为植片自溶(10例,30.3%)、HSK复发(8例,24.3%)、植片细菌感染(6例,18.2%)、免疫排斥(4例,12.1%)、Mooren溃疡复发(4例,12.1%)与真菌性角膜炎复发(1例,3.0%).结论感染性角膜病是导致角膜穿孔最多见的原发病.其中HSK与真菌性角膜炎分别居于首位与第2位.1只眼多次发生角膜穿孔的原发病中,HSK与Mooren溃疡常见.植片自溶与HSK复发是角膜移植术后角膜再次穿孔的常见原因.
목적 분석비외상성각막천공적원발병,위적겁치료원발병예방각막천공적발생제공방조.방법 ,대산동성안과연구소1997년1월지2007년6월간377례비외상성각막천공주원환자(383지안)적병력자료진행회고성분석,관찰각막천공적원발병.결과 감염성각막병시도치각막천공최다견적원발병.기중,단순포진병독성각막염(herpes simplex keratitis,HSK)최다(145례,37.9%),기차위진균성각막염(95례,24.8%),재차위세균성각막염(52례,13.6%).8지안발생2차각막천공,원발병분별위HSK(4례)、Mooren궤양(2례)、배사성각공막염여세균성각막염각1례.33지안위각막이식술후식편천공,식편천공적원인의차위식편자용(10례,30.3%)、HSK복발(8례,24.3%)、식편세균감염(6례,18.2%)、면역배척(4례,12.1%)、Mooren궤양복발(4례,12.1%)여진균성각막염복발(1례,3.0%).결론 감염성각막병시도치각막천공최다견적원발병.기중HSK여진균성각막염분별거우수위여제2위.1지안다차발생각막천공적원발병중,HSK여Mooren궤양상견.식편자용여HSK복발시각막이식술후각막재차천공적상견원인.
Objective To analyze primary diseases of nontraumatic corneal perforation.hoping for help prevention of corneal perforation. Methods Records of 377 inpatients (383eyes) with corneal perforation in Shandong Eye Institute from January 1997 to June 2007 were retrospectively analyzed, with primary diseases observed. Results Infectious corneal diseases were the most primary disease of corneal perforation,in which the most pathogens were herpes simplex virus ( 145 cases; 37.9％), followed by fungi (95; 24.8％ )and bacteria (52:13.6％ ). Corneal perforations occurred twice in 8 eyes, of which the primary diseases were herpes simplex keratitis (HSK, 4 cases), Mooren's ulcer (2), necrotizing keratitis and scleratitis ( 1 ), and bacterial keratitis (1). The implanted corneas perforated in 33 eyes, in which causes of perforation included implants autoproteolysis ( 10 eases; 30.3％ ), HSK recurrence ( 8; 24.3％).bacterial infections (6; 18.2％ ),immunological rejection (4; 12.1％ ), recurrence of Mooren's ulcer (4; 12.1％), and fungal recurrence (1;3.0％ ). Conclusions Infectious corneal diseases are the predominating primary diseases of corneal perforations, of which HSK and fungal keratitis are in the first and second place, respectively. In the same eyes with repeated perforation, HSK and Mooren's ulcers are common primary diseases. Implants autoproteolysis and HSK recurrence are the main causes of graft perforation after keratoplasty.