恶性青光眼的治疗与护理

目的:探讨青先眼术后发生恶性青光眼的治疗与护理。方法:通过观察16例青光眼术后患者发生恶性青光眼的治疗与护理。结果:通过有效规范的护理与治疗,16例患者中药物治疗好转1例,药物治疗无效后行氩激光治疗2例、后巩膜放液加前房成形术3例、晶状体切除加前段玻璃体切除术6例,人工晶状体植入联合小梁切除术4例。随诊0.5 a～2 a,眼压≤21 mmHg 14例,眼压>21 mmHg 2例。结论:应用各种治疗方法,重点观察患者前房深度、眼压的变化,做好用药护理,加强术前、术后护理,尤其是术前心理护理和术后出院指导更为重要,是保证恶性青光眼治疗成功的关键。     

青光眼滤过术后浅前房的分析与处理

目的：探讨青光眼滤过术后浅前房与术前眼压等相关因素的关系以及术后并发症的处理分析。方法：回顾总结各类型青光眼的滤过性手术178例（196眼）术后发生浅前房的情况。结果：术后发生浅前房32眼（16．33％），术前眼压≤21mmHg者146眼中发生浅前房14眼（9．59％），术前眼压22—30mmHg者30眼发生浅前房10眼（33．33％），术前眼压≥30mmHg者中20眼发生浅前房8眼（40.00％）。结论：青光眼滤过术后浅前房与术前眼压有关，术前眼压控制正常者发生低；根据术后并发症的不同给予不同的处理。     

急性闭角型青光眼持续高眼压的手术治疗

目的:探讨持续高眼压状态下急性闭角型青光眼手术治疗的方法和疗效。方法:对使用多种药物3天不能控制眼压(≥40 mmHg)的56例(56眼)患者施行小梁切除术。术前尽量降低眼压,术中少量、缓慢、多次释放房水,使用可调整缝线,术后恢复前房防止眼压过低。结果:未出现脉络膜上腔爆发性出血和恶性青光眼。术后患眼视力0.01～0.1 16眼,0.1～0.8 40眼,均好于术前高眼压状态下视力(P0.01)。术后眼压≤21 mmHg 48眼。较术前明显降低(P0.01)。术后3例脉络膜脱离,2例滤过过强致前房迟缓形成,2例滤过不畅致高眼压,均经过治疗后恢复。结论:持续高眼压急诊行小梁切除术是可行而且必要的。     

13例原发性急性闭角型青光眼高眼压下行小梁切除术的护理

目的总结持续高眼压状态下进行小梁切除术治疗原发性急性闭角型青光眼患者的护理经验。方法重点做好患者术前的心理护理、健康指导、眼部及全身的检查,术后加强对低眼压性浅前房、前房出血、恶性青光眼并发症的观察,及时联合药物治疗并采取相应的护理措施。结果13例患者心理状态稳定,密切配合治疗,术前平均眼压49mmHg,术后眼压控制在13～19mmHg,视功能未见进一步受损。结论加强手术前后的护理,采取相应的护理措施,可为手术成功提供保证。     

眼球挫伤继发性青光眼48例临床分析

目的分析眼球钝挫伤继发性青光眼的分型和治疗方法。方法分析48例眼球钝挫伤继发性青光眼的临床表现、分型、发病机制及治疗方法。结果48例患者根据临床表现分为眼内出血性、房角后退性、晶状体相关性3种类型。单纯药物治疗26例,药物治疗联合前房冲洗6例,前房冲洗联合小梁切除术2例,前段玻璃体切除术联合小梁切除术4例,小梁切除术术中加用丝裂霉素6例,后段玻璃体切除术4例。治疗后随访3～6个月,未使用任何降压药物,眼压正常者32例;眼压＆gt;21mmHg仍需合并使用降压药物14例,2例低眼压。结论眼球钝挫伤继发性青光眼临床表现多样,导致高眼压机制复杂,应根据具体发病机制采取针对性治疗方法。     

恶性青光眼的临床观察

目的探讨恶性青光眼的预防和治疗。方法回顾性分析2001年7月-2007年5月我院经治的14例14眼恶性青光眼的临床资料。结果我院住院治疗各种类型青光眼患者382例,发生恶性青光眼14例,其中小梁切除术后11例,白内障超声乳化及人工晶状体植入联合小梁切除术后1例,发生于新生血管性青光眼行Ahmed阀植入术后1例,急性闭角型青光眼术前缩瞳后发生1例。术后随访眼压平均15.1±3.5mmHg,全部前房深度恢复且稳定,视力保持,无严重并发症。结论小梁切除术为恶性青光眼最常见原因,早期发现、早期药物治疗能有效治愈各种恶性青光眼。     

Ahmed青光眼阀植入术治疗恶性青光眼的临床疗效研究

目的:观察Ahmed青光眼阀植入术治疗恶性青光眼的临床疗效及术后不良反应。方法:对我院收治的16例(17眼)恶性青光眼患者根据手术指征进行Ahmed青光眼阀植入术,观察术后2个月的视力、眼压、前房深度及并发症等情况,并与术前进行分析比较。结果:所有病例术后前房深度均≥2.5CT;眼压控制在7.1~18.6mmHg,平均眼压(11.37±2.24)mmHg,与术前相比眼压有明显降低。16例患者在随诊期间均未发生眼内炎、脉络膜脱离及角膜内皮失代偿等严重并发症。结论:Ahmed青光眼阀植入术治疗恶性青光眼的临床效果好,值得临床推广和应用。     

原发性闭角型青光眼滤过术后恶性青光眼的临床分析

目的探讨原发性闭角型青光眼滤过术后恶性青光眼的临床特点。方法选择2008年1月~2016年8月在我院治疗的1215例原发性闭角型青光眼患者的临床资料进行回顾性分析。所有患者均行原发性闭角型青光眼滤过术治疗。其中有16例发生术后恶性青光眼,给予药物治疗、手术治疗或者激光治疗。记录患者一般资料、临床资料,比较急性闭角型青光眼与慢性闭角型青光眼患者不同年龄段术后恶性青光眼发生率;比较术后恶性青光眼患者与未发生术后恶性青光眼患者术前中央前房深度、眼轴长度;比较不同发病时间患者药物治疗第3天平均眼压;统计患者治疗效果。结果女性的发病率较高,术后恶性青光眼患者年龄更大,术前中央前房深度浅,眼轴长度短,差异有统计学意义(P0.05)。术后1周内发病患者药物治疗第3天平均眼压(28.35±6.11)mmHg,术后1周后发病者药物治疗第3天平均眼压(50.10±13.35)mmHg,差异有统计学意义(P0.05)。结论高龄、女性、术前中央前房深度浅、眼轴长度短的患者更容易发生术后恶性青光眼,术后发病时间越晚药物治疗效果越差,临床上应积极给予药物治疗、手术治疗,以及时控制病情。     

青光眼持续高眼压行小梁切除术27例临床观察

目的:探讨小梁切除术治疗青光眼持续高眼压的效果.方法:对27例(27眼)青光眼持续高眼压患者行小梁切除术,观察术后视力、眼压、前房深度及并发症.结果:手术均顺利完成,术中及术后无爆发性脉络膜上腔出血及恶性青光眼发生.术后前房积血5眼,浅前房10眼,经治疗积血吸收,浅前房恢复.术后1周视力提高18眼,有24眼(88.89%)不用药物眼压控制在21 mmHg以下.结论:对局部及全身联合应用降眼压药物眼压仍无法控制的青光眼,应积极采取手术治疗,可缩短病程,疗效满意.     

小梁切除术后恶性青光眼的联合手术疗效分析

目的探讨前部玻璃体切除、晶状体超声乳化、后囊切开联合人工晶体植入治疗小梁切除术后恶性青光眼疗效。方法自2008年11月～2011年5月对10例10眼中小梁切除术后恶性青光眼、经保守治疗及前房成形术无效者,以前部玻璃体切除、晶状体超声乳化、后囊切开联合人工晶体植入治疗。结果全部患者人工晶体囊带内植入,前方形成,眼压稳定在11～21mmHg7例,5mmHg1例,作B超发现脉络膜脱离,用激素治疗10d后恢复。2例眼压21～30mmHg,考虑粘弹剂吸出不彻底,给用药及侧切口适量放出前房水后,1例眼压2d后恢复至14mmHg,1例经3d恢复至12mmHg,矫正视力得到不同程度的提高。结论①超声乳化晶状体摘除联合前部玻璃体切除是治疗小梁切除术后恶性青光眼、经保守治疗及前房成形术无效者有效术式;②后囊切开或YAG激光后囊造孔沟通房水流出途径,解除房水迷流是前房形成的保证;③人工晶体囊带内植入是视力恢复的保障。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.