结膜瓣遮盖术联合结膜下注射氟康唑治疗重症真菌性角膜溃疡

Therapeutic effects of conjunctival flap covering combined with subconjunctival injection of fluconazole on patients with severe fungal corneal ulcer

目的:分析结膜瓣遮盖术联合结膜下注射氟康唑治疗重症真菌性角膜溃疡患者的临床疗效。方法:选取2012-01/2015-12收治的重症真菌性角膜溃疡患者50例50眼作为观察对象,随机分为观察组与对照组,每组25例25眼。对照组采取单纯药物治疗,观察组在对照组的基础上加入结膜瓣遮盖术。观察两组患者的临床疗效、矫正视力及不良反应发生率,并随访1a观察两组患者复发情况。结果:治疗1mo后,观察组临床疗效显著高于对照组(P<0.05),观察组矫正视力高于对照组(P<0.05),且在不良反应发生率方面低于对照组,差异有统计学意义(P<0.05);随访1a发现观察组仅有1例患者复发,对照组有8例患者复发,观察组复发率显著低于对照组,差异有统计学意义(P<0.05)。结论:结膜瓣遮盖术联合结膜下注射氟康唑在重症真菌性角膜溃疡患者中具有较好的应用价值,能够有效提高患者的临床疗效,改善患者的视力情况,同时能够有效降低不良反应发生率和复发率。

AIM ：To analyze the clinical efficacy of conjunctival flap covering combined with subconjunctival injection of fluconazole on patients with severe fungal corneal ulcer. METHODS： Totally 50 cases with severe fungal corneal ulcer were collected in our hospital from January 2012 to December 2015. The cases were randomly divided into observation group and control group, 25 cases in each group. All the cases were monocular sick. The control group took single drug treatment, but the observation group were given with conjunctival flap as an extra. The clinical efficacy, best corrected visual acuity and adverse effects rate were observed. And, the relapse of the two groups was followed for la. RESULTS： After l mo of treatment, the clinical curative effect of the observation group was significantly higher than the control group （ P〈 0.05）, and corrected visual acuity of the observation group was higher than the control group （P〈0.05） ; the adverse reaction rate of the observation group was lower than the control group （ P〈 0.05）. After la followup, the observation group only had 1 case of recurrence, control group had 8 cases with recurrence, the recurrence rate of the observation group was significantly lower than the control group （P〈0. 05）. CONCLUSION： The conjunctival flap combined with subconjunctival injection of fluconazole has good application value in severe fungal corneal ulcer patients, can effectively improve the clinical curative effect and the visual acuity, and can effectively reduce the incidence of adverse reactions and recurrence rate.