385例行穿透性角膜移植术患者的回顾性分析

Abstract

目的：对2008~2013年间于我院行穿透性角膜移植术患者的流行病学状况进行回顾性分析，汇总患者多方面流行病学特征从而为预防和早期治疗提供指导依据。方法：收集整理我院6年间共计385例(385眼)行穿透性角膜移植术患者的详细病历资料，按照国内外统一标准对其进行分类统计，回顾性总结行穿透性角膜移植术患者的流行病学状况，具体分析其适应症分布、病因分布、年龄分布、职业分布和手术目的分布等情况。结果：6年来，各种原因导致的感染性角膜溃疡为我院行穿透性角膜移植术的主要适应证，占总数的54.5%，其次为圆锥角膜(23.6%)和角膜白斑(10.6%)。其中，角膜真菌性感染占感染性角膜溃疡的80%左右，病毒性角膜溃疡(53.7%)反复发作为角膜白斑致病的主要原因。年龄分布以41~60岁左右的中年患者(47.5%)居多，职业分布以农民(64.2%)、工人(20.3%)为主。患者行穿透性角膜移植术的目的多以治疗性(61.6%)为主。结论：治疗感染性角膜溃疡的早期需及时检测和明确致病病原体，采取有针对性的治疗措施可有效地抑制病原体的增殖入侵，从而降低角膜移植率。 Objective: By analyzing the epidemiological situation of patients who did penetrating corneal trans-plantation in our hospital from 2008 to 2013, we find out the epidemiological characteristics for prevention and early treatment. Methods: We collected the data of 385 patients who accepted pene-trating corneal transplantation in six years. These cases were classified in accordance with the uni-fied domestic and abroad standard, such as indication, etiology, age, vocation and purpose distribu-tion. The epidemiological situation of penetrating corneal transplantation cases were summarized retrospectively. Results: In 6 years, most of the indications of penetrating corneal transplantation cases were infective corneal ulcer caused by various reasons, accounted for 54.5%, followed by ke-ratoconus (23.6%) and keratoleukoma (10.6%). The fungal infection was accounted for about 80% among the infective corneal ulcer. The recurrent occurrence of viral corneal ulcer (53.7%) was a leading cause of keratoleukoma. Age distribution showed that most of the patients were at their middle age from 41 to 60 years old (47.5%). The main components of professional distribution were farmers (64.2%) and workers (20.3%). The main reason of penetrating corneal transplantation cases was for therapeutic purposes (61.6%). Conclusion: Penetrating corneal transplantation is the most classic and effective method to treat corneal diseases of visual impairment. During the treat-ment of infective corneal ulcer, we need to detect and confirm the pathogens timely and to take cor-responding measures to restrain the proliferation and invasion of pathogens. Consequently, we can reduce the rate of penetrating corneal transplantation surgery.