發(fā)布時(shí)間：2018-02-13 22:19

  本文關(guān)鍵詞： 穿透性角膜移植術(shù) 免疫排斥反應(yīng) 臨床防治　出處：《吉林大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:總結(jié)我院自2007年1月至2009年6月行穿透性角膜移植術(shù)并有術(shù)后定期隨訪患者的臨床病例,對(duì)患者的年齡、病因、術(shù)前患眼情況及伴隨癥狀等與角膜移植排斥反應(yīng)的關(guān)系進(jìn)行分析,探討排斥反應(yīng)發(fā)生機(jī)理,并對(duì)排斥反應(yīng)進(jìn)行治療。 方法:對(duì)行穿透性角膜移植術(shù)的104例(104只眼)進(jìn)行回顧性研究。 結(jié)果:本組病例行穿透性角膜移植術(shù)的最常見病因?yàn)榻悄ぐ装?共49例,占總數(shù)47.1%,這與患眼的病程和某些客觀原因有關(guān);第二位的病因?yàn)楦腥拘越悄ぱ?共28例,占總數(shù)46.4%,其中真菌性角膜炎又為多發(fā)病因,共有20例,占71.4%;其次為大泡性角膜病變,共7例,占總數(shù)6.7%;角膜膿腫4例,占3.8%,角膜變性和角膜營養(yǎng)不良5例,占4.8%;其它8例,占7.6%。 術(shù)前患眼的伴隨癥狀也是影響術(shù)后免疫排斥反應(yīng)發(fā)生率的主要原因之一。本組病例中患眼伴隨癥狀多且復(fù)雜,主要有角膜新生血管,虹膜粘連,陳舊性虹膜睫狀體炎,術(shù)前淺前房和虹膜新生血管。從總體上看,虹膜粘連、角膜新生血管、陳舊虹膜睫狀體炎、前房積膿這些患眼伴隨癥狀所導(dǎo)致的術(shù)后免疫排斥反應(yīng)發(fā)生率高。 本組104例中,發(fā)生排斥反應(yīng)有38例。排斥反應(yīng)發(fā)生率為36.5%。排斥反應(yīng)發(fā)生的時(shí)間跨度大,最早的發(fā)生在術(shù)后29天,多數(shù)發(fā)生在3個(gè)月以后,也有在術(shù)后一年出現(xiàn)排斥反應(yīng)的。 對(duì)于術(shù)后發(fā)生排斥反應(yīng)治療為局部或全身激素及免疫抑制劑治療。但結(jié)合臨床觀察,排斥反應(yīng)的早期發(fā)現(xiàn)和早期治療很重要。
[Abstract]:Objective: to summarize the clinical cases of penetrating keratoplasty performed in our hospital from January 2007 to June 2009, and to evaluate the age and etiology of the patients. The relationship between preoperative ocular condition and associated symptoms and corneal allograft rejection was analyzed, and the mechanism of rejection was discussed, and the rejection was treated. Methods: 104 cases (104 eyes) with penetrating keratoplasty were studied retrospectively. Results: the most common cause of penetrating keratoplasty was corneal leukoplakia (49 cases), accounting for 47.1% of the total, which was related to the course of the affected eyes and some objective causes, and the second cause was infectious keratitis (28 cases). Among them, fungal keratitis was the most common cause, accounting for 71.4%, 7 cases (6.7%) of macrovesicular keratopathy; 4 cases of corneal abscess (3.8%), 5 cases of corneal degeneration and corneal dystrophy (4.8 cases); and 8 cases of other 8 cases (7.6%). The concomitant symptoms of the eyes before operation were also one of the main factors affecting the incidence of postoperative immune rejection. In this group, the associated symptoms were many and complicated, including corneal neovascularization, iris adhesion, and old iridocyclitis. Generally speaking, the incidence of postoperative immune rejection caused by iridia adhesion, corneal neovascularization, obsolete iridocyclitis and anterior chamber pyosis were high. There were 38 cases of rejection in 104 cases. The incidence of rejection was 36.5%. The earliest time span of rejection occurred in 29 days after operation, most of which occurred after 3 months, and there was also rejection in one year after operation. Local or systemic hormone and immunosuppressant are used in the treatment of postoperative rejection, but combined with clinical observation, the early detection and early treatment of rejection is very important.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R779.65

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本文編號(hào)：1509230