本文選題：兒童角膜移植　切入點(diǎn)：穿透性角膜移植　出處：《眼科》2017年04期

【摘要】：目的分析兒童穿透性角膜移植術(shù)的病因、手術(shù)方式、植片透明率、排斥反應(yīng)發(fā)生率及影響排斥反應(yīng)的相關(guān)因素。設(shè)計(jì)回顧性病例系列。研究對(duì)象北京同仁眼科中心2008年1月至2013年12月穿透性角膜移植手術(shù)的12歲以下患兒81例(81眼)。方法根據(jù)年齡分為嬰幼組(0~3歲,49眼)和兒童組(4歲~12歲,32眼)。術(shù)后平均隨訪(38.72±21.46)個(gè)月�；仡櫥颊叩牟v資料。主要指標(biāo)患者年齡、術(shù)前診斷、手術(shù)方式、術(shù)后植片透明度。結(jié)果病因主要為先天性角膜混濁占82.72%;后天外傷性占6.17%,后天非外傷性占11.11%(其中感染性角膜炎3.70%,圓錐角膜角膜3.70%、移植術(shù)后植片失敗3.70%)。先天性角膜混濁在嬰幼組占93.88%,兒童組占65.63%(P0.01)。手術(shù)方式中單純穿透性角膜移植術(shù)(PKP)占80.25%,其中嬰幼組89.80%(44/49),兒童組75.00%(24/32)(P0.05)。末次隨訪時(shí)總體植片透明率85.19%,其中嬰幼組81.63%(40/49),兒童組90.63%(29/32)(P0.05)。先天性因素者術(shù)后排斥率15.22%(7/46),后天性因素中活動(dòng)性炎癥導(dǎo)致角膜潰瘍并穿孔(1/1)和植片失敗進(jìn)行再次角膜移植手術(shù)(3/3)的術(shù)后植片排斥率極高。結(jié)論 12歲以下兒童穿透性角膜移植的主要病因?yàn)橄忍煨越悄せ鞚�。雖然兒童角膜移植難度大,但仍具備一定的成功條件。兒童穿透性角膜移植植片存活率有所提高。
[Abstract]:Objective to analyze the etiology, operative method, graft transparency rate, rejection rate and related factors of penetrating keratoplasty in children.Design retrospective case series.Participants 81 children under 12 years of age who underwent penetrating keratoplasty from January 2008 to December 2013 were enrolled in the study.Methods according to the age, the infant group was divided into 3 years old group (49 eyes) and the children group (12 years old, 32 eyes).The average follow-up was 38.72 鹵21.46 months.The patient's medical records were reviewed.Main outcome measures Age, preoperative diagnosis, operative method, transparency of grafts after operation.Results the main etiology was congenital corneal opacity (82.72), postnatal trauma (6.17), acquired non-traumatic (11.11) (infective keratitis 3.70, keratoconus 3.70), graft failure 3.70 after transplantation.Congenital corneal opacity was 93.88 in infantile group and 65.63 in infantile group.PKP of penetrating keratoplasty was 80.25%, including 89.80% in infant group and 75.00% in child group.At the last follow-up, the overall transparency rate of grafts was 85.19, including 81.63% 40 / 49% in infant group and 90.63% 32% in children group (P 0.05).The postoperative rejection rate of congenital factors was 15.2222 / 7 / 46, and the rejection rate of corneal ulcer and perforation caused by active inflammation in acquired factors was 1 / 1 / 1) and the rejection rate of graft was 3 / 3 / 3).Conclusion congenital corneal opacity is the main cause of penetrating keratoplasty in children under 12 years old.Although corneal transplantation is difficult in children, it still has certain successful conditions.The survival rate of penetrating keratoplasty in children was improved.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心眼科學(xué)與視覺科學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R779.65

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周道伐;;用新鮮和冷凍保存的角膜作穿透性角膜移植[J];角膜病雜志;1980年01期

2 閻亦農(nóng)，，郝繼龍，張瑞雪;穿透性角膜移植拆線并發(fā)癥[J];白求恩醫(yī)科大學(xué)學(xué)報(bào);1994年06期

3 魏文斌;穿透性角膜移植治療虹膜角膜內(nèi)皮綜合征二例[J];眼科研究;1994年02期

4 閻亦農(nóng)，郝繼龍;穿透性角膜移植密集縫合法[J];白求恩醫(yī)科大學(xué)學(xué)報(bào);1995年03期

5 王莉，董克云;穿透性角膜移植手術(shù)配合[J];蚌埠醫(yī)學(xué)院學(xué)報(bào);1996年05期

6 李平,黃菊天,葛鈞,羅小玲,劉志遠(yuǎn),肖瓊;平衡鹽溶液保存角膜用于穿透性角膜移植的研究[J];中國基層醫(yī)藥;2000年04期

7 曹建琴,周麗鈞,董凌峰;穿透性角膜移植聯(lián)合白內(nèi)障摘除人工晶體植入術(shù)的臨床探討[J];第三軍醫(yī)大學(xué)學(xué)報(bào);2001年09期

8 楊方耀,伍桂軍,丁偉,高付林,付瑞;200例穿透性角膜移植臨床研究[J];中國實(shí)用眼科雜志;2001年07期

9 吳曉民,王家平,伍桂軍;穿透性角膜移植35例臨床分析[J];福建醫(yī)藥雜志;2001年02期

10 謝立信,史偉云,郭萍;角膜緣干細(xì)胞移植術(shù)后的穿透性角膜移植療效觀察[J];中華眼科雜志;2002年09期

相關(guān)會(huì)議論文 前3條

1 吳護(hù)平;吳國基;蔡錦紅;劉昭升;陳燕;;兒童穿透性角膜移植手術(shù)并發(fā)癥原因的臨床觀察及防治原則[A];中華醫(yī)學(xué)會(huì)第十二屆全國眼科學(xué)術(shù)大會(huì)論文匯編[C];2007年

2 李東豪;陳林;聞毅

本文編號(hào)：1711670