角膜溃疡清创术联合抗真菌药物治疗真菌性角膜炎的效果观察

Observation on the Effect of Corneal Ulcer Debridement Combined with Antifungal Drugs in the Treatment of Fungal Keratitis

目的:分析真菌性角膜炎(FK)采用角膜溃疡清创术联合抗真菌药物治疗的效果。方法:选择桐梓县人民医院2022年1月—2023年12月收治的FK患者64例,按照随机数字表法分为对照组与观察组,各32例。对照组采用抗真菌药物治疗,观察组采用角膜溃疡清创术联合抗真菌药物治疗。比较两组临床疗效、症状消失时间、角膜溃疡面积、视力、眼部症状评分。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.023)。观察组角膜溃疡、畏光流泪、眼部异物感消失时间短于对照组,差异有统计学意义(P<0.01)。观察患者治疗后3d、治疗后4周角膜溃疡面积小于对照组,差异有统计学意义(P<0.05)。治疗后,观察组患者视力改善情况优于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后4周眼部症状评分低于对照组,差异有统计学意义(P<0.001)。结论:FK采用角膜溃疡清创术联合抗真菌药物治疗可快速缩小溃疡面积,加快症状消失时间,改善患者眼部症状及视力,提升疗效。

Objective:To analyze the effect of fungal keratitis(FK)treated with corneal ulcer debridement combined with antifungal drugs.Methods:Sixty-four cases of FK patients admitted to Tongzi County People's Hospital from January 2022 to December 2023 were selected and divided into the control group and observation group according to the randomized numerical table method,each with thirty-two cases.The control group was treated with antifungal drugs,and the observation group was treated with corneal ulcer debridement combined with antifungal drugs.Compare the clinical efficacy,symptom disappearance time,corneal ulcer area,visual acuity,and ocular symptom scores of the two groups.Results:The total treatment efficiency of the observation group was higher than that of the control group,and the difference was statistically significant(P=0.023);the disappearance time of corneal ulcer,photophobia and tearing,and ocular foreign body sensation of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.01);the area of corneal ulcers of the observation patients was smaller than that of the control group at 3 d after the treatment and at 4 weeks after the treatment,and the difference was statistically significant(P<0.05);after treatment,the improvement of visual acuity of patients in the observation group was better than that of the control group,and the difference was statistically significant(P<0.05);the scores of ocular symptoms of patients in the observation group were lower than that of the control group 4 weeks after treatment,and the difference was statistically significant(P<0.001).Conclusion:The treatment of FK with corneal ulcer debridement combined with antifungal drugs can rapidly reduce the ulcer area,accelerate the time of symptom disappearance,improve the patients'ocular symptoms and visual acuity,and enhance the efficacy of treatment.