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两性霉素B眶内冲洗治疗鼻眶毛霉菌病

Intraorbital Irrigation of Amphotericin B in the Treatment of Rhino-Orbital Mucormycosis.

作者信息

Joos Zachary P, Patel Bhupendra C K

机构信息

Department of Ophthalmology and Visual Sciences, Division of Ophthalmic Plastic and Reconstructive Surgery, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, U.S.A.

出版信息

Ophthalmic Plast Reconstr Surg. 2017 Jan/Feb;33(1):e13-e16. doi: 10.1097/IOP.0000000000000377.

Abstract

The aim of this study was to describe a modified technique of intraorbital irrigation of amphotericin B in the treatment of rhino-orbital mucormycosis. A 38-year-old man was diagnosed with rhino-orbital mucormycosis and subsequently underwent orbital and sinus debridement with postoperative intraorbital irrigation of amphotericin B. Daily irrigation of amphotericin B was infused in the orbit with measures taken to avoid iatrogenic toxicity to the ocular surface and gastrointestinal tract. The use of local amphotericin B irrigation directly in the orbit allowed for local control of infection without orbital exenteration, a good cosmetic outcome and excellent postoperative visual acuity. The published reports on the use of intraorbital irrigation with amphotericin B in mucormycosis infections were reviewed and the technique used at the institution was outlined.

摘要

本研究的目的是描述一种改良的两性霉素B眶内冲洗技术,用于治疗鼻眶毛霉菌病。一名38岁男性被诊断为鼻眶毛霉菌病,随后接受了眼眶和鼻窦清创术,并在术后进行了两性霉素B眶内冲洗。每天将两性霉素B注入眼眶进行冲洗,并采取措施避免对眼表和胃肠道造成医源性毒性。在眼眶直接使用局部两性霉素B冲洗可实现感染的局部控制,避免眼眶内容剜除术,获得良好的美容效果和出色的术后视力。本文回顾了已发表的关于在毛霉菌病感染中使用两性霉素B眶内冲洗的报告,并概述了该机构所采用的技术。

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