摘要
目的分析聊城市角膜炎患者病原学及预后影响因素。方法选取2017年1—12月聊城市光明眼科医院318例角膜炎患者,均通过角膜刮片、前房穿刺、培养鉴定、共焦镜检查等方法进行病原学分析。分析角膜炎患者的年龄、性别、职业特点、致病菌种类、季节特点、危险因素、病原分布,比较不同治疗方式及不同病原菌类型患者的住院时间、治疗前后视力。结果 318例角膜炎患者在性别、年龄方面未见明显特点;从事农业劳动患者的占比显著高于非农业劳动患者;外伤史、眼表慢性反复发作性疾病、角膜接触镜佩戴史等为角膜炎的危险因素。角膜炎一季度的发病率最高,达32.08%(102/318)。病毒性与细菌性角膜炎患者的占比较高,分别为50.00%(159/318)、31.44%(100/318),病毒性角膜炎的病原菌均为单纯疱疹病毒;细菌性角膜炎病原菌种类以革兰阴性杆菌与肺炎链球菌为主,分别占59.13%与33.04%;真菌以镰刀菌属最常见,占47.73%。238例患者采取药物保守治疗后治愈,80例采取手术治疗。保守治疗患者住院时间为(6.54±3.04)d,显著短于手术治疗患者的(24.30±8.11)d(t=22.848,P=0.000)。药物治疗患者治疗后的视力显著高于手术治疗患者(t=4.898,P=0.000)。病毒性角膜炎患者住院时间最短,为(12.85±5.76)d,显著短于细菌性、真菌性及细菌合并病毒性角膜炎患者的(18.54±6.99)、(20.19±7.58)、(18.68±7.17)d(F=32.816,P=0.000)。结论聊城市角膜炎以病毒性最常见,眼科医生应在高发季节做好预防工作,结合该地区角膜炎发病特点及耐药情况首选药物治疗,手术治疗应充分把握手术适应证及手术方式。
Objective To analyze the influencing factors of etiology and prognosis of patients with keratitis in Liaocheng. Methods 318 cases of patients with keratitis in Liaocheng Guangming Ophthalmologic Hospital from January to December 2017 were selected, for etiological analysis by the corneal scraping, anterior chamber puncture, culture identification and confocal microscopy, and the age, gender, occupational features, pathological type, season features, risk factor, and distribution of pathogens were analyzed, and the length of stay, and vision before treatment of patients in different treatment ways and different pathological types were compared between the two groups. Results There were no obvious features in gender and age of 318 cases of keratitis patients, and the ratio of patients engaged in agricultural work was obviously higher than that of patients engaged in the non-agricultural work, and the history of trauma, ocular surface chronic recurrent disease, contact lens wear history were the risk factors of keratitis, and the morbidity of keratitis in the first season was the highest, reaching 32.08%（102/318）, and the ratios of patients with viral and bacterial keratitis were the highest, respectively 50.00%（159/318）, 31.44%（100/318）, and the pathology of viral keratitis was the simple herpesvirus, and the bacterial keratitis was mainly gram negative bacilli and streptococcus pneumonia, respectively accounting for 59.13%, 33.04%; and the fusarium was the most common in epiphyte, accounting for 47.73%, 238 cases were cured after the drug conservative therapy, and 80 cases were treated with surgery, and the length of stay of patients with conservative therapy was obviously shorter than that of patients treated with surgery,[（6.54±3.04）d vs（24.30±8.11）d（t=22.848, P=0.000）], and the vision of patients after treatment was obviously higher than that of operative patients（t =4.898, P =0.000）, and the length of stay of patients with viral keratitis was the shortest,which was obviously short
作者
李孝才
LI Xiao-cai(Binzhou Medical College,Binzhou,Shandong Province,256603 China)
出处
《系统医学》
2018年第16期13-16,共4页
Systems Medicine
关键词
聊城市
角膜炎
病原学
预后
Liaocheng city
Keratitis
Etiology
Prognosis
