中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
1期
71-73
,共3页
祝磊%王应飞%黄亚琳%王璐璐%程志兴%张俊鸽%张荻%孙声桃%王丽娅
祝磊%王應飛%黃亞琳%王璐璐%程誌興%張俊鴿%張荻%孫聲桃%王麗婭
축뢰%왕응비%황아림%왕로로%정지흥%장준합%장적%손성도%왕려아
治疗性角膜移植%缝线侵蚀及周围脓疡%微生物学特点
治療性角膜移植%縫線侵蝕及週圍膿瘍%微生物學特點
치료성각막이식%봉선침식급주위농양%미생물학특점
Therapeutic corneal transplantation%Suture erosion and abscess%Microbial feature
目的 分析治疗性角膜移植术后缝线侵蚀及周围脓疡的微生物学和临床特点.方法 应用总结2年内连续发生的治疗性角膜移植术后缝线侵蚀和周围脓疡共11例,真菌角膜溃疡9例和复发性角膜基质炎合并穿孔2例.对病灶及结膜囊进行细菌和真菌培养,记录病灶的特点和治疗方法 与结果.结果 11例缝线侵蚀和周围脓疡均发生于术后3个月以内,平均31.8天.其中3例细菌培养阳性,2例结膜囊和缝线病灶培养菌种一致.病灶多发生在上方和睑裂区,其中上方为4例,占36.3%;发生在睑裂区3例,占27.3%.2例司时发生排斥反应.治疗方法 为及时拆除缝线,局部应用敏感抗生素,均l周内治愈.结论 治疗性角膜移植术后缝线侵蚀及周围脓疡发生较早,与眼睑摩擦、缝线松脱、术区污染、植床的炎症等有关.大部分为非感染性,少部分感染者多为革兰氏阳性菌.主要治疗措施是拆出侵蚀和松脱缝线,局部应用敏感抗生素.及时发现、及时治疗预后良好.
目的 分析治療性角膜移植術後縫線侵蝕及週圍膿瘍的微生物學和臨床特點.方法 應用總結2年內連續髮生的治療性角膜移植術後縫線侵蝕和週圍膿瘍共11例,真菌角膜潰瘍9例和複髮性角膜基質炎閤併穿孔2例.對病竈及結膜囊進行細菌和真菌培養,記錄病竈的特點和治療方法 與結果.結果 11例縫線侵蝕和週圍膿瘍均髮生于術後3箇月以內,平均31.8天.其中3例細菌培養暘性,2例結膜囊和縫線病竈培養菌種一緻.病竈多髮生在上方和瞼裂區,其中上方為4例,佔36.3%;髮生在瞼裂區3例,佔27.3%.2例司時髮生排斥反應.治療方法 為及時拆除縫線,跼部應用敏感抗生素,均l週內治愈.結論 治療性角膜移植術後縫線侵蝕及週圍膿瘍髮生較早,與眼瞼摩抆、縫線鬆脫、術區汙染、植床的炎癥等有關.大部分為非感染性,少部分感染者多為革蘭氏暘性菌.主要治療措施是拆齣侵蝕和鬆脫縫線,跼部應用敏感抗生素.及時髮現、及時治療預後良好.
목적 분석치료성각막이식술후봉선침식급주위농양적미생물학화림상특점.방법 응용총결2년내련속발생적치료성각막이식술후봉선침식화주위농양공11례,진균각막궤양9례화복발성각막기질염합병천공2례.대병조급결막낭진행세균화진균배양,기록병조적특점화치료방법 여결과.결과 11례봉선침식화주위농양균발생우술후3개월이내,평균31.8천.기중3례세균배양양성,2례결막낭화봉선병조배양균충일치.병조다발생재상방화검렬구,기중상방위4례,점36.3%;발생재검렬구3례,점27.3%.2례사시발생배척반응.치료방법 위급시탁제봉선,국부응용민감항생소,균l주내치유.결론 치료성각막이식술후봉선침식급주위농양발생교조,여안검마찰、봉선송탈、술구오염、식상적염증등유관.대부분위비감염성,소부분감염자다위혁란씨양성균.주요치료조시시탁출침식화송탈봉선,국부응용민감항생소.급시발현、급시치료예후량호.
Objective To investigate the microbial profiles and clinical features on suture erosions and abscesses after therapeutic corneal transplantation. Methods Of 11 consecutive cases of suture erosions and abscesses after therapeutic corneal transplantation were enrolled within 2 years, including 9 cases fugal keratitis and 2 cases recurrent stromal keratitis with perforation. In each case, both bacterial and fungal cultures were taken from eroded sutures and conjunctival sac. Clinical features on suture erosions and abscesses were recorded, including therapeutic regimen and results. Results All episodes of suture erosions and abscesses occurred within 3 months postoperatively, on average 31.8 days. Of the 11 cases, 3 had positive cultures and,suture and cul-de-sac cultured micro-organisms matched in 2 cases. Suture erosion and abscess were primarily located superior and palpebral fissure area, with 4 (36.3%) superiorly and 3 (27.3%) palpebrally. Graft rejection in 2 cases was determined clinically. Removal of involved sutures and sensitive topical antibiotic were employed and all cases healed within 1 week. Conclusions Suture erosions and abscesses after therapeutic corneal transplantation occur on early stage, associating with eyelid rubbing, loosening of sutures, contamination and inflammation of bed. Most cases are sterile, gram-positive bacteria are most common cultured organisms in infected ones. Therapeutic strategies are removal of involved sutures and sensitive topical antibiotic. Diagnosis and treatment in a timely fashion contribute to good prognosis.