济南市某医院角膜移植术362例的临床特征分析

Analysis of clinical characteristics of 362 cases of corneal transplantation in a hospital in Jinan

目的分析角膜移植患者的原发病变和手术方式。方法横断面研究。收集2021年1月至2023年12月济南市第二人民医院行角膜移植手术的362例角膜病患者的病历资料,所有患者接受角膜移植手术,统计分析患者的年龄、性别、籍贯、原发病变及手术方式。结果本研究患者的年龄为(51.79±19.35)岁;其中男228例,女134例,比例为1.70∶1。共计335例(92.54%)患者来自山东省,27例(7.46%)患者来自山东省外。占首位的角膜疾病为感染性角膜炎,共182例(50.28%),其余依次为角膜白斑60例(16.57%)、角膜内皮疾病39例(10.78%)、圆锥角膜29例(8.01%)、角膜皮样瘤25例(6.91%)、角膜变性与营养不良8例(2.21%)及其他19例(5.25%)。在182例感染性角膜炎中,真菌性角膜炎107例(58.79%),细菌性角膜炎43例(23.63%),病毒性角膜炎32例(17.58%)。按照角膜移植手术分类,穿透性角膜移植术205例(56.63%),板层角膜移植术135例(37.29%),角膜内皮移植术22例(6.08%)。结论角膜移植患者的原发病变中,感染性角膜炎占首位,其余依次为角膜白斑、角膜内皮疾病、圆锥角膜和角膜皮样瘤,而真菌感染则是感染性角膜炎的首位病因;穿透性角膜移植术仍为角膜移植手术的主要术式。

ObjectiveTo analyze the spectrum of primary diseases and surgical approaches of patients undergoing corneal transplantation.MethodsA cross-sectional study was conducted.Medical records of 362 patients with corneal diseases who underwent corneal transplantation surgery in Jinan Second People’s Hospital from Jan.2021 to Dec.2023 were selected for statistical analysis.The age,gender,place of origin,primary corneal diseases,and surgical methods of the transplant recipients were analyzed.ResultsThe average age of the patients was(51.79±19.35)years;the ratio of male(228 cases)to female(134 cases)was 1.70∶1.Three hundred and thirty-five patients(92.54%)were from Shandong province,and 27 patients(7.46%)were from outside Shandong province.The leading cause of corneal disease was infectious keratitis in 182 cases(50.28%),followed by corneal leukoma in 60 cases(16.57%),corneal endothelial disease in 39 cases(10.78%),keratoconus in 29 cases(8.01%),corneal dermoid in 25 cases(6.91%),corneal degeneration and malnutrition in 8 cases(2.21%),and other causes in 19 cases(5.25%).Among the 182 cases with infectious keratitis,fungal keratitis accounted for 107 cases(58.79%),bacterial keratitis for 43 cases(23.63%),and viral keratitis for 32 cases(17.58%).In terms of corneal transplantation surgery,penetrating keratoplasty was performed in 205 cases(56.63%),lamellar keratoplasty in 135 cases(37.29%),and endothelial keratoplasty in 22 cases(6.08%).ConclusionInfectious keratitis is the primary cause of corneal disease in patients undergoing corneal transplantation,followed by corneal leukoma,endothelial corneal disease,keratoconus,and corneal dermoid,with fungi being the leading cause of infectious keratitis.Penetrating keratoplasty is still the main surgical procedure.