中国中部地区引起角膜穿孔的原发病因调查

目的:对导致我国中部地区角膜穿孔患者的原发病因进行回顾性分析,为其干预预防与治疗提供依据。方法:回顾2006-2010年间在武汉大学人民医院住院的角膜穿孔患者的病例资料,分析角膜穿孔的原发病因。结果:角膜穿孔合计为348只眼,其中11例患者为双眼发生角膜穿孔。眼外伤是角膜穿孔最常见的病因(56.3%),其中角膜穿通伤所占比例最高(63.3%),以下依次为爆炸伤(25.5%)、热烧伤(9.2%)、化学伤(2%)。感染性角膜病位居第2(37.6%),其中真菌性角膜炎所占的比例最高(37.4%),其次为病原菌不明性角膜炎34眼(26.0%)、细菌性角膜炎26眼(19.8%)、单纯疱疹性角膜炎21眼(16.0%)。有5只眼发生2次角膜穿孔,其原发病分别为单纯疱疹性角膜炎(HSK)(2眼)、Mooren’s溃疡(2眼)与碱烧伤(1眼)。11眼发生双眼角膜穿孔,分别为爆炸伤(7眼)、碱烧伤(4眼)。结论:眼外伤是导致角膜穿孔的最常见因素,其中以穿通伤及爆炸伤危害性最大。感染性角膜病是导致角膜穿孔的第2危险因素,其中以真菌性角膜炎危害性最大。HSK、Mooren’s溃疡易导致穿孔反复发作。由于角膜穿孔的并发症多且危害大,并会对患者的生存质量造成严重影响,因此通过本调查应重视对其预防与早期治疗。

Cause Analysis of Corneal Perforation in Central China

Objective: To analyze the primary diseases of corneal perforation in order to provide evidences for the prevention and treatment.Methods: The data of inpatients from central China diagnosed as corneal perforation in our ophthalmologic center from January 2006 to December 2010 were retrospectively analyzed,and the primary diseases of corneal perforation were recorded and analyzed.Results: A total of 348 eyes of inpatients with corneal perforation were involved,in which corneal perforation occurred in both eyes in 11 cases.Ocular trauma(56.3%) was the most common cause of corneal perforation,and next was infectious corneal diseases(37.6%).In ocular trauma,the percentage of corneal penetrating injury was the highest(63.3%),followed by explosion injury(25.5%),thermal burn(9.2%),and chemical injury(2%).In infectious corneal diseases,the most pathogens were fungi(37.4%),followed by undetermined origins(26.0%),bacteria(19.8%),and herpes simplex virus(42.2%).Corneal perforations occurred 2 times in 5 eyes,in which the primary diseases were herpes simplex keratitis(HSK)(2 cases),Mooren’s ulcer(2 cases) and alkali burn(1 case).Binocular corneal perforation occurred in 11 eyes,in which the primary diseases were explosion injury(7 cases) and alkali burn(4 cases).Conclusion: Ocular trauma and infectious corneal diseases are the most and the second common primary diseases causing corneal perforation.HSK and Mooren’s ulcers are common causes of repeated corneal perforation.The complications are often common and serious in the patients with corneal perforation,so prevention and early treatment are very important in clinic.