摘要
目的探讨真菌混合革兰阳性球菌性角膜炎的疗效。方法观察38例真菌混合革兰阳性球菌性感染性角膜炎患者,经角膜刮片检查并活体共焦显微镜检查均找到真菌孢子和(或)菌丝及革兰阳性球菌。采用局部清创后2%碘伏烧灼,5%那他霉素滴眼液点眼1次/h;注射用头孢唑林钠皮试(-)者,用头孢唑林钠溶液,点眼1次/h,2周后减量。根据病情的轻重,可加用口服伏立康唑片抗真菌治疗。结果 2例患者因不能遵医嘱,1例耐药,致病情加重。余35例均治愈,溃疡愈合,形成角膜瘢痕,染色阴性。结论联合药物治疗真菌混合革兰阳性球菌性角膜炎疗效显著,能明显降低其致盲率。
Objective To observe the treatment results ofmixed fungal and gram positive bacterialkeratitis in 38 patients.Methods Fungal hyphae or spores and gram positive bacteria were found in the corneal scraping and in vivo confocal microscopy imaging in 38 patients.Corneal ulcer was cauterized with 2% iodine after local debridement,and 5% natamycin eye drops was given hourly.For those cefazolin skin test was negative,cefazolin sodium eye drops were also given hourly.Oral voriconazolewas administrated to severe cases.Results Mixed fungal and bacterial keratitis was cured in 35 patients,manifested as healing of the corneal ulcer,formation of scar,and negative in staining.In 3 patients the keratitis aggravated.2 of them did not follow doctor’s advice and 1 was found to have developed drug resistance.Conclusions In this study,combined medication has a significant therapeutic effect on mixed fungal and gram positive bacterial keratitis and can reduce the probability of blindness.
出处
《临床眼科杂志》
2017年第5期444-446,共3页
Journal of Clinical Ophthalmology
