浙南地区外伤性真菌性角膜炎的人口学及临床特征

Demographic and clinical characteristics of traumatic fungal keratitis in Southern Zhejiang Province

目的分析浙南地区外伤性真菌性角膜炎患者的人口学及临床特征。方法收集2016年1月至2020年12月温州医科大学附属眼视光医院外伤后真菌性角膜炎562例(562眼)的临床资料,回顾性分析其人口学特征、致病因素、致病菌属、用药史、临床体征及治疗方式;结果农民为主要患病人群,共332例(59.1%)。41〜80岁年龄段为主,共484例(86.2%)。男女比例为2.7:1。主要分布地区为温州市鹿城K共65例(11.6%),植物外伤为主要致病因素,共225例(40.0%)。主要致病菌属为镰刀菌属163例(41.6%)413例(73.5%)可见明显溃疡灶:130例(23.1%)接受手术治疗。联合角膜共焦显微镜、刮片镜检、培养鉴定,阳性检出率为95.7%(201/210)。结论中老年男性农民为主要患病人群,镰刀菌属是主要的致病菌属,植物伤是主要致病菌素。联合角膜共聚焦显微镜.刮片镜检,培养鉴定这者检查能提高外伤性真菌性角膜炎阳性检出率。

Objective To analyze the demographic and clinical characteristics of patients with traumatic fungal keratitis in Southern Zhejiang Province.Methods The clinical data of 562 eyes of 562 patients with fungal keratitis from Jan.2016 to Dec.2020 in the Eye Hospital Affiliated to Wenzhou Medical University were collected.The demographic characteristics,pathogenic factors,pathogenic bacteria,medication history,clinical signs and treatment methods were analyzed retrospectively.Results Farmers were the main group,accounting for 59.1%(332/562).The main age was 41-80 years,accounting for 86.2%(484/562),and the ratio of male to female was 2.7:1.The main distribution area was Lucheng District of Wenzhou,accounting for 11.6%(65/562).Plant injury was the main pathogenic factor,accounting for 40.0%(225/562).The main pathogens were Fusarium accounting lor 41.6%(163/562).Totol of 413 cases(73.5%)showed obvious ulcer and 130 cases(23.1%)received surgical treatment.And the positive detection rate of confocal microscopy comhined with scraping microscopy and culture identification was 95.7%(201/210).Conclusion The middle-aged and old male farmers are the main patients,and Fusarium is the main pathogenic-bacteria.Combining confocal microscopy,scraping microscopy and culture identification can improve the positive detection rate of fungal keratitis.