微量激素联合抗细菌药物治疗细菌性角膜溃疡的临床探讨

Low concentration of corticosteroids combined with antibiotics for treating bacterial corneal ulcer

目的探讨微量激素联合抗菌素治疗细菌性角膜溃疡的可行性,并评价其疗效和安全性。方法选择2008年2月至2010年6月收治的细菌性角膜炎患者38例(39眼),随机分为两组,分别施以抗生素治疗或联合加用低浓度皮质类固醇治疗。患者随访8～12个月,平均(10±2)个月。观察视力、角膜透明度、新生血管以及治疗时间。结果激素组20例21眼在治疗后6～36d,平均9d,角膜上皮完全愈合,炎症后角膜遗留斑痕程度明显轻于未用激素组。结论皮质类固醇激素在角膜炎治疗过程中能使角膜炎症反应和组织损害减少到最低限度,加速溃疡的愈合,减轻角膜瘢痕。说明细菌性角膜炎治疗中运用低浓度皮质类固醇激素是一种简单可行、实用有效的方法。

Objective To evaluate the efficacy of low concentration of corticosteroids combined with antibiotics for treating bacterial corneal ulcer.Methods Thirty-nine eyes of 38 patients were studied from February 2008 to June 2010,which divided into two groups randomly.One group was used antibiotics,and another group was treated with antibiotics combined with low concentration corticosteroids.The visual acuity,transparency of cornea,neovascularization and treatment time of patients were observed.All patients had been followed up for 8-12months.Results The corneal epithelium of 21 eyes（20 patients） in the group using corticosteroids completely healed in 6 to 36 days after treatment,with the average of 9 days,and the cornea scarring is lighter significantly than the patients in the other group.Conclusion Using corticosteroid properly in the medication of keratitis can minimize the inflammatory and impairment of cornea,promote healing of ulcer,and alleviate corneal scarring.