探讨共聚焦显微镜在感染性角膜炎诊断及疗效判定中的应用
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摘要
目的研究分析感染性角膜炎使用共聚焦显微镜(in vivo confocal microscopy,IVCM)诊断的价值。方法 2011年3月—2015年3月对我院接收的感染性角膜炎患者98例进行分析,治疗前进行共聚焦显微镜诊断,角膜刮片镜检,真菌培养,然后进行保守治疗,对失败的患者进行角膜移植和眼内容物剜除。患者治疗两周和1个月后分别再次进行共聚焦显微镜诊断。结果接受保守治疗的患者,病原菌平均浸润深度为(64.37±8.85)μm,手术治疗患者的病原菌平均浸润深度为(69.52±9.71)μm。治疗两周后治愈率是0,1个月后的治愈率是67.3%。结论共聚焦显微镜对感染性角膜炎的诊断以及疗效判断具有很高的价值,为临床治疗以及预后分析提供了参考。
Objective To study the value of in vivo confocal microscopy(IVCM) in the diagnosis of infectious keratitis. Methods From March 2011 to March 2015, 98 cases of infectious keratitis in our hospital were analyzed. Confocal microscopy, corneal scraping, and fungal culture were performed before treatment, conservative treatment was then performed. The failure of patients with corneal transplantation and orbit evisceration. Confocal microscopy was performed again after two and 1 months of treatment. Results the average infiltration depth of pathogenic bacteria was(64.37 ± 8.85) μm, and the average depth of invasive bacteria was(69.52 ± 9.71) μm in patients receiving conservative treatment. After two weeks of treatment, the cure rate was 0, and the cure rate was 67.3% after 1 months. Conclusion Confocal microscopy is of great value in the diagnosis and judgement of curative effect of infectious keratitis, and provides a reference for clinical treatment and prognosis analysis.
Objective To study the value of in vivo confocal microscopy(IVCM) in the diagnosis of infectious keratitis. Methods From March 2011 to March 2015, 98 cases of infectious keratitis in our hospital were analyzed. Confocal microscopy, corneal scraping, and fungal culture were performed before treatment, conservative treatment was then performed. The failure of patients with corneal transplantation and orbit evisceration. Confocal microscopy was performed again after two and 1 months of treatment. Results the average infiltration depth of pathogenic bacteria was(64.37 ± 8.85) μm, and the average depth of invasive bacteria was(69.52 ± 9.71) μm in patients receiving conservative treatment. After two weeks of treatment, the cure rate was 0, and the cure rate was 67.3% after 1 months. Conclusion Confocal microscopy is of great value in the diagnosis and judgement of curative effect of infectious keratitis, and provides a reference for clinical treatment and prognosis analysis.
引文
[1]熊健,周文天.活体共聚焦显微镜在感染性角膜炎诊断应用进展[J].中国实用眼科杂志,2014,32(8):934-938.
[2]王学勇,王绪梅.共聚焦显微镜在真菌性角膜炎中的应用[J].国际眼科杂志,2011,11(2):311-312.
[3]梁庆丰,孙旭光,LABBE Antoine.活体共聚焦显微镜在感染性角膜炎诊治中的应用[J].中华眼科杂志,2013,49(10):951-955.
[4]谢春梅.感染性角膜溃疡行羊膜移植术患者的围手术期护理观察[J].大家健康(下旬版),2014,8(3):300-301.
[5]周晓棠,周小涛,刘青云,等.碘伏烧灼联合氟康唑治疗真菌性角膜炎[J].中国现代药物应用,2011,5(10):72-73.
[6]杨敏天,娄启阳.角膜炎的病原菌分布及耐药性研究[J].中华医院感染学杂志,2013,23(2):356-358.
[7]肖卉,张德艳,范忠义.感染性角膜炎466例共焦显微镜检查结果临床分析[J].国际眼科杂志,2014,14(10):1825-1827.
[8]史伟云,王婷.我国真菌性角膜炎诊断和治疗中的几个问题[J].中华眼科杂志,2013,49(1):2-5.
[2]王学勇,王绪梅.共聚焦显微镜在真菌性角膜炎中的应用[J].国际眼科杂志,2011,11(2):311-312.
[3]梁庆丰,孙旭光,LABBE Antoine.活体共聚焦显微镜在感染性角膜炎诊治中的应用[J].中华眼科杂志,2013,49(10):951-955.
[4]谢春梅.感染性角膜溃疡行羊膜移植术患者的围手术期护理观察[J].大家健康(下旬版),2014,8(3):300-301.
[5]周晓棠,周小涛,刘青云,等.碘伏烧灼联合氟康唑治疗真菌性角膜炎[J].中国现代药物应用,2011,5(10):72-73.
[6]杨敏天,娄启阳.角膜炎的病原菌分布及耐药性研究[J].中华医院感染学杂志,2013,23(2):356-358.
[7]肖卉,张德艳,范忠义.感染性角膜炎466例共焦显微镜检查结果临床分析[J].国际眼科杂志,2014,14(10):1825-1827.
[8]史伟云,王婷.我国真菌性角膜炎诊断和治疗中的几个问题[J].中华眼科杂志,2013,49(1):2-5.