312例化脓性角膜溃疡的病因和病原分析

Analysis of the Cause and Pathogen of the Pyogenic Corneal Ulcer in 312 Cases

１９９２年６月至１９９３年１２月确诊３１２例化脓性角膜溃疡，原因不明引起者１９６例，占６２．８２％；外伤引起者８５例，占２７．２４％；单疱病毒引起者２５例，占８．０１％；戴隐形眼镜引起者６例，占１．９０％。３１２例中有１９７例（６３．１４％）使用过激素，２９３例（９３．９１％）使用过抗菌素。感染的病原为真菌１４６例（４６．７９％）、表皮葡萄球菌７３例（２３．４０％）、金黄色葡萄球菌４３例（１３．７８％）、绿脓杆菌２０例（６．４１％），并发现两例棘阿米巴原虫感染。对７８例真菌性角膜溃疡同时进行细菌培养，有４４例混合感染，占５６．４１％。真菌常伴有表皮葡萄球菌（１９例，４３．１８％）和金黄色葡萄球菌（１６例，３６．３６％）感染。

hree hundred and twelve cases of the pyogenic corneal ulcer were diagnosed from June 1992 throughDecember 1993.Among 312 cases ,no remote cause was found in 196 cases (62.82%),85 cases(27. 24%)was caused by trauma, 25 cases(8. 01%)by herpes simplex keratitis and 6 cases.90%)by contact lenses.There were 197 cases(63.14%)treated with hormone and 293 cases (93. 91%)treated with antibiotics. In-fective pathogens were fungus (146 cases ,23. 40%),epidernudis staphy(73 cases ,23. 40%),aureus staphy(43 cases,178%),pseudomonas aeruginosa(20 cases,6. 41%)and acanthamoeba(2 case.78 casesoffungus corneal ulcer were examined by bacterial culture at the same time. There were44 cases (56. 4%)as-sociated with bacterial infection. Fungus infection was often accompanied with epidermidis staphy(19 cases,43. 18%)and aureus staphy(16 cases,36. 36%)infection.