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目的探讨真菌性角膜炎的组织病理学改变与临床分型及治疗的关系。方法对经87例真菌性角膜炎者术后病变角膜组织进行病理学检查并对照各菌种之间的组织病理学变化。结果病理组织损害为广泛化脓性炎症,病理切片可见病变区角膜上皮细胞缺损,炎细胞环绕溃疡部位大量浸润分布,距病灶较远处的基质层其细胞浸润明显减少并将其与正常角膜组织相隔离,PAS染色可见溃疡边缘的板层纤维内大量菌丝,真菌菌丝在角膜基质内的生长无明显规律,可与角膜板层平行、斜行或垂直生长,部分标本浅基质层为坏死组织覆盖而不易找见菌丝。结论病理检查对确定真菌在角膜内的生长情况、临床分型及指导临床选择手术方式有帮助,但各菌种之间的组织病理学改变无明显差异。
Objective To investigate the relationship between histopathological changes and clinical classification and treatment of fungal keratitis. Methods The histopathological changes of the corneal tissues in 87 cases of fungal keratitis were examined by pathological examination. Results Pathological tissue damage was extensive purulent inflammation. Pathological examination showed that the corneal epithelial cells in the lesion area were infiltrated with a large infiltration of inflammatory cells around the ulcer site. The infiltration of cells in the stroma farther away from the lesion was significantly reduced and compared with the normal corneal tissue phase Isolation, PAS staining showed a large number of mycelium in the lamellar layer of the edge of the ulcer, fungal mycelium growth in the corneal stroma no obvious law, with corneal lamellar parallel, oblique or vertical growth, some of the specimens shallow stromal layer of necrotic tissue Cover and easy to find mycelium. Conclusion Pathological examination is helpful to determine the growth of fungi in the cornea, clinical classification and clinical choice of surgical procedures, but no significant difference in histopathological changes among the various strains.