小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果观察

目的观察小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果及安全性。方法选取2011-02～2012-02该院眼科收治的639例白内障患者,随机分成两组,实验组339例采用小切口非超声乳化囊外摘除人工晶体植入术,对照组300例采用超声乳化手术,比较两组术后视力恢复情况及并发症发生情况。结果实验组的疗效优于对照组（P＜0.05）,两组并发症发生率比较差异无统计学意义（P＞0.05）。结论小切口非超声乳化囊外摘除人工晶体植入术治疗白内障有较好的临床疗效及安全性,是治疗白内障的主要方法,具有重要的临床应用价值。     

小切口非超声乳化与超声乳化治疗老年性白内障疗效比较

目的 比较小切口非超声乳化与超声乳化治疗老年性白内障疗效.方法 对近期152例170眼老年性白内障患者,年龄61～78(平均68)岁,分别行该两种手术,并进行回顾性总结分析.结果 小切口非超声乳化白内障摘除术及人工晶体植入术与超声乳化白内障摘除术及人工晶体植入术1 w后的术后视力水平、散光程度、角膜中央厚度以及角膜内皮水肿程度相比无显著差异.结论 小切口非超声乳化与超声乳化治疗老年性白内障疗效相似.     

两种手术治疗老年白内障的疗效与并发症比较

目的对小切口非超声乳化白内障摘除继人工晶体植入与超声乳化白内障摘除继人工晶体植入两种手术治疗老年性白内障的疗效及其并发症进行比较。方法选择眼科治疗的老年性白内障患者211例,年龄65～80岁。行小切口非超声乳化手术治疗患者102例,平均年龄(73.26±4.31)岁;行超声乳化手术治疗患者109例,平均年龄(72.58±3.21)岁;对两种手术的疗效及并发症进行回顾性分析。结果术中、术后均无严重并发症发生;术后1个月,行两种手术的老年性白内障患者其视力水平、散光程度、角膜中央厚度以及角膜内皮水肿程度相比均无明显差异(P>0.05)。通过术后1个月的随访,术后裸眼视力水平均有不同程度的提高,散光程度、角膜中央厚度及角膜内皮水肿程度与术前相比,无明显差异(P>0.05)。结论老年性白内障患者采用小切口非超声乳化白内障摘除继人工晶体植入与超声乳化白内障摘除继人工晶体植入两种手术均是安全、有效的治疗措施。两种手术具有创伤小、疗程短及并发症少的优点。     

小瞳孔行表麻下3.5mm切口手法碎核白内障手术探讨

目的探讨小瞳孔行表麻下3.5mm切口手法碎核白内障摘除联合人工晶体植入术的手术技巧、注意事项及疗效。方法 58例核硬度为Ⅱ~Ⅳ级,充分散瞳后瞳孔直径在1.0~4.0mm的患者行白内障摘除联合人工晶体植入术。其中最重要的步骤是前囊膜的处理,不同情况下处理方法不同。根据瞳孔粘连闭合程度分为:瞳孔缘粘连而无机化膜者;瞳孔区有薄机化膜者;后粘连主要集中于瞳孔区,且机化膜较厚者等。结果术后56眼(96.6%)视力较术前提高,其中视力≥0.6者19眼,0.3~0.5者30眼,0.1~0.2者7眼。术后瞳孔均呈圆形或椭圆形,直径1.5~3.5mm。术中无后囊膜破裂、悬韧带离断、前房出血;术后早期有少量轻微并发症,用药后均缓解;术后远期无明显并发症。结论对小瞳孔行表麻下3.5mm切口手法碎核白内障摘除联合人工晶体植入术的手术,术前需因人而异精心设计制定个性化的手术方案,术后均可取得良好的手术效果。     

分析糖尿病合并白内障患者行两种不同手术方式的临床效果

目的分析对比糖尿病合并白内障患者行两种不同方式白内障手术的临床效果。方法选取2018年10月—2020年11月该院收治糖尿病合并白内障患者70例,根据治疗方法不同分为对照组(小切口白内障摘除联合人工晶体植入术)和观察组(超声乳化吸除联合人工晶体植入术),各35例,观察两组患者的临床血糖指标水平、并发症情况以及者裸眼视力。结果观察组患者HbA1c、FPG、2 hPG等血糖指标与对照组,差异无统计学意义(P>0.05);观察组患者角膜水肿、后囊破裂、前房炎性渗出、黄斑水肿以及低血糖等并发症发生率与对照组差异无统计学意义(P>0.05);观察组患者术后裸眼视力提高优于对照组,差异有统计学意义(P<0.05)。结论对糖尿病合并白内障患者实施超声乳化吸除联合人工晶体植入术是安全有效的,能使患者得到更好的术后视力,跟小切口白内障摘除联合人工晶体植入术相比更有其优势。     

小瞳孔下白内障超声乳化及人工晶状体植入术临床观察

对27例(27眼)小瞳孔白内障患者术中应用黏弹剂直接扩大瞳孔,然后行环形撕囊、超声乳化吸除白内障及人工晶状体植入.术后视力均有提高,＞0.5者17眼、0.3～0.5者7眼、0.1～0.2者3眼;瞳孔圆形或近圆形;术中后囊膜破裂1眼;术后角膜水肿3眼,一过性高眼压5眼.认为小瞳孔下白内障超声乳化及人工晶状体植入术也可取得良好的手术效果.     

小切口非超声乳化白内障摘除术联合巩膜咬切术的疗效

目的探讨小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术治疗成熟期年龄相关性白内障合并急性闭角型青光眼的临床疗效。方法对2013年1¹2月在吉林大学第二医院白内障科就诊的成熟期年龄相关性白内障合并急性闭角型青光眼患者27例(27眼),年龄5612月在吉林大学第二医院白内障科就诊的成熟期年龄相关性白内障合并急性闭角型青光眼患者27例(27眼),年龄56⁷8岁,平均69岁,行小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切三联术,观察术后1 w、1、3个月的裸眼视力、最佳矫正视力及眼压控制状况,判定手术疗效。结果小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术术后裸眼视力,最佳矫正视力均较术前明显好转,术后眼压得到有效控制。结论小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术能有效控制眼压,提高视力,是较为安全可靠的治疗成熟期年龄相关性白内障合并急性闭角型青光眼的手术方式。     

小切口非超声乳化摘除并人工晶体植入术治疗糖尿病白内障的效果评价

目的评价小切口非超声乳化摘除并人工晶体植入术治疗糖尿病白内障的干预效果。将该院收治的2013年3月—2014年11月确诊并收治的94例糖尿病合并白内障患者编入研究组,同时选取同期收治的94例无糖尿病白内障患者编入对照组。两组均实施小切口非超声乳化摘除并人工晶体植入术治疗。治疗后随访1年,其中术后6个月返院复查视力,并统计术中及术后并发症。结果全部患者手术成功,治疗后6个月时复查视力均高于0.3。对照组治疗后视力0.5以上患者比率为94.7%,显著优于研究组的81.9%(χ~2=7.41,P=0.00)。单就研究组未发生眼底病变患者来看,其视力0.5以上患者比率为91.4%,与对照组无显著差异(χ~2=0.26,P=0.61)。单就研究组合并眼底病变患者来看,其视力0.5以上患者比率为54.2%,与对照组差异显著(χ~2=23.43,P=0.00)。研究组并发症发生率为47.9%,显著高于对照组的24.5%(P0.05)。两组并发症经相应处理干预后均治愈。结论小切口非超声乳化摘除并人工晶体植入术治疗糖尿病白内障可促进患者视力的显著恢复,未合并眼底病变的糖尿病白内障患者可获得与正常白内障患者几近等同的疗效,且后续不良反应均可顺利根除,值得临床应用。     

老年2型糖尿病性白内障的术后疗效评价

目的　探讨白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗老年 2型糖尿病性白内障的疗效。方法　选择老年 2型糖尿病性白内障患者 52例 (59眼 )。 31例 (36眼 )为 ～ 级核 ,采用现代白内障囊外摘除 -后房型人工晶体植入术。 2 1例 (2 3眼 )为 ～ 级核 ,采用超声乳化白内障吸除后房型人工晶体植入术。结果　术后疗效评价采用术前和术后平均裸眼视力等级资料配对秩和检验。结果术后裸眼视力≥ 0 .5者占 54.2 % ,≥ 0 .3者占 94.8%。术前和术后裸眼视力有非常显著差异 (Z=4.70 7,P<0 .0 0 0 1 )。结论　白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗老年 2型糖尿病性白内障疗效肯定 ,94.8%患眼视力改善≥ 0 .3。     

小切口非超声乳化人工晶状体植入术治疗老年性白内障38例

老年性白内障为我国最主要的致盲眼病,白内障摘除术目前仍是治疗的主要方法.传统手术切口大、术中术后并发症多、散光大、愈合慢、住院时间长[1,2].本研究观察小切口非超声乳化白内障人工晶体植入术治疗老年性白内障的效果.     

冠状动脉小血管支架植入的临床研究

目的：观察冠状动脉小血管病变患者的临床特点、支架植入情况及预后效果。方法：回顾分析冠状动脉小血管严重狭窄患者的临床及支架植入资料，并与同期进行的冠脉大血管支架患者进行比较，比较二者的临床特点、手术方法及预后的异同。结果：冠脉小血管支架组植入成功率97．14％，大血管支架组植入成功率98．95％（P〉0．05）；两组在年龄、性别及高血压患病率方面组间比较差异无统计学意义（P〉0．05），2型糖尿病患病率在小血管支架组高于大血管支架组（P〈0．05）；植入方法上，使用球囊预扩的比例两组比较差异无统计学意义（P〉0．05）；支架释放后球囊后扩张比例小血管支架组低于大血管支架组（P〈0．05）；术中并发症及随访期预后差异元统计学意义（P〉0．05）。结论：冠状动脉小血管支架植入的成功率、预后与大血管支架组无显著差异，可安全地用于冠脉小血管病变的治疗。     

Chemotherapy induced small bowel obstruction in small cell lung cancer

Lung cancer is the leading cause of cancer related death in men and the second cause in women worldwide. We describe a case of a 51- year old lady with small cell lung cancer who developed small bowel obstruction following chemotherapy with cisplatin and etoposide. Abdominal CT scan showed changes confined to the jejunum and proximal ileum with diffuse mural thickening and hyper-attenuation of the mucosa with sparing of the terminal ileum, caecum and colon. Her condition improved with conservative management and intravenous antibiotics.     

An interesting coexistence: small bowel volvulus and small bowel diverticulosis.

Acquired (non-Meckel's) jejuno-ileal diverticular disease is uncommon, and most surgeons have limited, if any, experience with this condition. We present an interesting case with coexistence of small bowel diverticulum and small bowel volvulus with massive abdominal distension, in which the patient had a history of abdominal distension without abdominal pain over a five-year period. A brief discussion of the common clinical features is given and the principles of treatment of jejuno-ileal diverticular disease and small bowel volvulus are presented. A 29-year- old man with no history of laparotomy was admitted with abdominal distension and abdominal compartment syndrome symptoms. An emergency laparotomy revealed 180 degree clockwise volvulus of the multiple diverticula-bearing terminal ileum. There was no diverticulum in other sites of the small intestine and colon. Additionally, there was neither adhesion nor any congenital anomalies at the other sites of the gastrointestinal system. The viability of the intestine was normal but the diameter of the ileum was extremely enlarged (approximately 20 cm). In addition, the bowel wall was also hypertrophied. The rotated and enormously enlarged diverticula-bearing small intestine was removed with cecum, and ileocolostomy was performed. The patient was discharged uneventfully from hospital on the eighth postoperative day. After the operation, all symptoms of the patient disappeared. Small bowel obstruction is a common cause of emergency surgical admission. Awareness of the fact that volvulus of the diverticula-bearing segment of the jejuno- ileum is a rare cause of small bowel obstruction may lead to earlier and prompt diagnosis and treatment.     

Gene expression in the adapting small bowel after massive small bowel resection

Background Intestinal adaptation occurs in the residual bowel following the loss or resection of a proportion of the small bowel. The purpose of the adaptive response is to return absorptive and digestive properties to near normal levels. This study employed a rat model of massive small bowel resection (MSBR) to study the adaptive response in the residual terminal ileum and the jejunum. The time points were chosen to reflect changes in gene expression early on in the response, because these are the genes that alter to initiate and maximize the response observed during adaptation. Methods Sprague Dawley rats underwent an 80% resection. Differential display polymerase chain reaction (DD-PCR) analysis was performed on mRNA extracted from the remnant ileum and jejunum 0, 1, 2, 4, and 7 days post-MSBR. Results DD-PCR identified 11 genes that were possibly regulated following MSBR. Genes confirmed to be regulated were 16S ribosomal RNA, lymphocyte antigen 6 (LY6)-like molecule, Krüppel-like factor-3 (KLF-3), G-protein-binding protein (CRFG), system A transporter 2 (SAT2), and an intestine-specific gene (similar to mKIAA0493). Conclusions DD-PCR analysis showed regulation of a number of genes not previously known to be involved in adaptation after MSBR or previously characterized in the intestine. These genes may be important in bringing about the complement of changes seen during the adaptive response.     

Stenting small coronary arteries

Stenting of small coronary arteries was long contra-indicated because of a high rate of subacute occlusion. We report a single-center registry including 190 patients stented with 2.5 mm balloons. Procedural success was 98% and subacute occlusion rate was 2.6%. Clinical follow-up showed a 24.5% repeat intervention rate. These results seemed acceptable, warranting stent implantation in small arteries in the case of acute or threatened closure. New stent designs and coatings may contribute to the improvement of outcomes and to the decrease in subacute occlusion and restenosis rates.