感染性巩膜溃疡的临床经验：翼状胬肉手术的一种并发症
Clinical experiences of infectious scleral ulceration: a complication of pterygium operation.
作者信息
Lin C P, Shih M H, Tsai M C
机构信息
Department of Ophthalmology, Kaohsiung Medical College, Taiwan, ROC.
出版信息
Br J Ophthalmol. 1997 Nov;81(11):980-3. doi: 10.1136/bjo.81.11.980.
AIMS
To report the special clinical manifestations and determine the appropriate management of infectious scleral ulceration.
METHODS
A retrospective study was performed on 30 eyes with infectious scleral ulceration. Information was recorded on patients' age, onset and course of disease, pathogenic organism, clinical presentations, methods of diagnosis, treatment, and outcome.
RESULTS
10 cases (33.3%) were accompanied by corneal involvement. Subconjunctival abscess was noted in 16 cases (53.3%). 17 cases (56.7%) gave positive results of pathogen culture and all were Pseudomonas aeruginosa. Two cases had combined bacterial infections and one case was complicated by fungal infection. A total of 26 cases had surgical debridement in this series. Extensive involvement of the sclera with the presence of a 'tunnel lesion' or a 'satellite subconjunctival abscess' were found during debridement. All of the eyeballs involved were salvaged except one.
CONCLUSION
The results of this study were contrary to the poor prognosis presented in previous reports. Early and repetitive surgical debridement is believed to be mandatory in the intractable cases to shorten the admission period and to save these eyes.
目的
报告感染性巩膜溃疡的特殊临床表现并确定适当的治疗方法。
方法
对30例感染性巩膜溃疡患者的眼部进行回顾性研究。记录患者的年龄、疾病的发病情况和病程、致病微生物、临床表现、诊断方法、治疗方法及治疗结果。
结果
10例（33.3%）伴有角膜受累。16例（53.3%）出现结膜下脓肿。17例（56.7%）病原体培养呈阳性，均为铜绿假单胞菌。2例合并细菌感染，1例合并真菌感染。本系列共有26例接受了手术清创。清创过程中发现巩膜广泛受累，存在“隧道病变”或“卫星结膜下脓肿”。除1只眼外，所有受累眼球均得以挽救。
结论
本研究结果与以往报道的预后不良情况相反。对于难治性病例，早期反复手术清创被认为是必要的，以缩短住院时间并挽救这些眼球。
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