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1.
目的探讨羊膜手术治疗急性期眼表疾病的手术方式和临床疗效。方法对51例(60只眼)保守治疗无效的急性期眼表疾病患眼分别行单纯羊膜移植术(32只眼)、羊膜移植联合羊膜遮盖术(24只眼)和(或)羊膜填充术(4只眼)治疗。术后观察不同方式羊膜手术同原眼病的预后、植片转归、角膜上皮的愈合、新生血管和假性胬肉的侵入、睑球黏连等情况的关系。随访期为4~12个月,平均9.4个月。结果在39只急性角膜溃疡的患眼中,有30只眼给予1次手术治愈、有6只眼给予第2次羊膜手术后治愈、有3只眼(2只为真菌性角膜溃疡,1只为棘阿米巴角膜溃疡)在羊膜手术失败后给予深板层角膜移植手术治愈。在12只化学性烧伤的患眼中,所有患眼术后均未见角膜进行性融解或穿孔,随访期内角膜表面逐渐血管化,未见睑球黏连永久性形成。在蚕蚀性角膜溃疡的6只患眼中,5只眼给予单次羊膜手术于随访期内未见复发,1只眼最终复发以板层角膜移植治愈。结论在保守治疗无效的前提下,针对不同的眼表疾病应给予不同方式的羊膜手术治疗。  相似文献   

2.
羊膜移植治疗眼表疾病的临床研究   总被引:2,自引:0,他引:2  
目的:探讨羊膜移植治疗眼表疾病的临床效果。方法:采用甘油保存的人羊膜对复发性翼状胬肉8例(10例),睑球粘连4例(4眼),结膜肿瘤2例(2眼),大泡性角膜病变2例(2眼)进行治疗,手术方法:清除眼表病变组织,分离眼表粘连组织后进行羊膜移植治疗,并随访观察术后疗效。结果:随访3-10个月,16例(18眼)羊膜移植后未发现羊膜排斥性溶解及感染现象,复发性翼状胬肉8例(10眼)无一例复发,4例睑球粘连得到改善或解除,2例大泡性角膜病变患者疼痛症状明显减轻,2例结膜肿瘤术后1例未见复发,另1例术后1个月复发,结论:保存的人羊膜无抗原性,具有促进上皮愈合,抗纤维化,抗新生血管,抗炎及抗粘连作用,是理想的基底膜,羊膜移植是治疗眼表疾病的有效方法。  相似文献   

3.
目的:观察新鲜羊膜移植治疗眼表面疾病的临床效果。方法:采用新鲜羊膜移植治疗原发性翼状胬肉、复发性翼状胬肉、眼化学烧伤、眼表肿瘤、睑球粘连、霉菌性角膜炎、浅结膜囊共46例52眼,随访3~10个月。结果:所有52眼均未发生急性排斥反应。术后翼状胬肉、眼表肿瘤和睑球粘连均没有复发,睑球粘连者均恢复了眼球的运动功能。化学烧伤2眼再次接受了新鲜羊膜移植后痊愈;霉菌性角膜溃疡1眼羊膜溶解后穿孔。结论:新鲜羊膜是治疗眼表面疾病、重建眼表结构的一种有用的材料,但是必须选好适应证。  相似文献   

4.
目的:探讨急性炎症期及瘢痕期以及增殖性病变引起的眼表疾病新鲜羊膜移植的可行性并对其疗效进行评价。方法:选择本院急性化学伤、热灼伤4例(5只眼)复发性蚕蚀性角膜溃疡7例(7只眼)角膜缺损16例(16只眼)瘢痕性复发性翼状胬肉及各种原因引起的大面积睑球粘连25例(33只眼)共计52例(61只眼)分别行单纯新鲜羊膜移植术35例(44只眼)羊膜联合板层角膜移植16例(16只眼)羊膜联合角膜缘移植术5例(5只眼)术后均经印记细胞学追踪观察移植后羊膜上皮细胞存活的时间,术后随诊6~17个月,平均11个月。结果:新鲜羊膜移植的52例患者术后临床上均未见羊膜植片急性排斥反应。急性眼烧伤的5只眼中术后4只眼无角结膜进行性溶解和穿孔,无新生血管和假性胬肉侵入角膜表面,虹膜无萎缩,视力可有不同程度提高。复发性蚕蚀性角膜溃疡7只眼术后未见复发,严重睑球粘连的33只眼中有30只恢复了眼球活动功能,有3只眼术后3~6个月再次发生睑球粘连。结论:新鲜角膜移植可有效的用于重建角结膜表面,减轻炎症反应减少新生血管的形成,抑制纤维组织增生,同时可用于防止蚕蚀性角膜溃疡的复发充分清除眼表病变组织和羊膜移植片的缝合固定对羊膜移植重建眼表功能极其重要。  相似文献   

5.
目的:观察和探讨保存羊膜联合自体球结膜移植治疗复发性睑球粘连的临床效果和价值。方法:采用保存羊膜联合自体球结膜移植,治疗复发性胬肉、化学烧伤等原因所致的睑球粘连患者38例共38只眼。观察6~36个月。结果:38例患者38只眼术后无一例感染,10d后移植的羊膜变透明,并在结膜表面爬行,3个月后的结膜蛋白印迹法显示,羊膜上结膜上皮生长良好。34只眼(89.5%)术后眼球运动功能恢复良好,4只眼(10.5%)再次复发部分睑球粘连。结论:保存羊膜联合自体球结膜移植治疗复发性睑球粘连。是一种有效可行的方法。  相似文献   

6.
深低温保存羊膜在眼表疾病中的应用   总被引:2,自引:1,他引:1  
目的:探讨保存羊膜在眼表疾病中的应用。方法:选择眼表疾病患者54例(56眼),根据不同病情,均在常规手术或联合皮瓣修补、角膜移植基础上采用深低温保存人羊膜移植,重建缺损的眼表面。结果:所有患者术后炎症反应轻,眼表重建稳定。随访5-24个月,平均15.5个月,外伤31眼中23眼术后粘连解除,结膜缺损修复,眼表重建满意;8眼因烧伤严重部分改善,其中2眼半年后经再次羊膜移植彻底修复。复发性翼状胬肉患者10眼中1眼轻度复发。持续性角膜上皮缺损伴溃疡及义眼台暴露患者15眼均治愈。结论:保存羊膜移植对大部分严重眼表疾病具有良好的治疗作用。  相似文献   

7.
程德才  余舜 《河北医学》2007,13(11):1322-1325
目的:观察新鲜羊膜移植对翼状胬肉及严重睑球粘连临床疗效的影响。方法:采用新鲜羊膜移植治疗翼状胬肉及严重睑球粘连56例73只眼,其中翼状胬肉37例49只眼,各种原因导致的大面积睑球粘连19例24只眼。翼状胬肉患者中复发性翼状胬肉为11例,初发性翼状胬肉为38只眼。手术均在显微镜下完成。结果:术后随访6~18个月,平均为12个月,93.2%(5/73)羊膜移植手术均一次成功,临床上均未见新鲜羊膜植片急性排斥反应。翼状胬肉患者除3只眼2月后复发外,其余全部均一次性治愈;严重睑球粘连24眼中,22只眼恢复了眼球的运动功能,2只眼术后3个月再次发生睑球粘连,但粘连面积较术前明显减小。结论:新鲜羊膜移植是治疗翼状胬肉及睑球粘连的有效方法。  相似文献   

8.
目的 探讨保存人羊膜移植治疗眼烧伤等眼表疾病的临床效果。方法 采用保存人羊膜移植治疗 5 1例( 5 8眼 )眼表疾病 ,其中翼状胬肉 2 6例 ( 33眼 ) ,急性碱烧伤 3例 ,慢性化学性烧伤 15例 ,大泡性角膜病变 4例 ,眼表良性肿瘤 3例。结果 术后无一例眼发生感染 ,除一例急性碱烧伤患者于术后第 5天羊膜溶解、脱落外 ,其余患者术后羊膜植片平伏 ,术后 1~ 4周内正常上皮沿羊膜表面生长 ,成功重建眼表。经过平均 11.2± 5 .6个月的随访观察 ,翼状胬肉者中 5眼复发 ,手术成功率为 84 .8% ,复发率为 15 .2 % ,3例急性碱烧伤者出现角膜结膜化 ,未能获得长期稳定的眼表 ,慢性化学性烧伤者角膜新生血管明显减轻 ,睑球粘连松解 ,视力有不同程度改善 ,其余病例眼表稳定 ,效果显著。结论 保存的人羊膜移植能安全、有效地重建部分眼表疾病患者的眼表 ,但对急性严重碱烧伤患者的远期疗效不理想。  相似文献   

9.
目的:探讨羊膜移植在眼表疾病治疗中的临床效果及手术方法。方法:对30例(33眼)眼表疾病施行羊膜移植术,其中翼状胬肉17例(20眼),复发性翼状胬肉3例,严重角膜溃疡6例,角膜化学伤3例,睑球连粘1例。结果:30例(33眼)术后羊膜全部成活,形成稳定的眼表。5例胬肉遮盖角膜中央,6例严重角膜溃疡,3例角膜化学伤在术后视力均有不同程度提高。结论:羊膜移植可有效地重建眼表获得较好的临床效果。  相似文献   

10.
羊膜移植治疗严重眼表面疾病的临床观察   总被引:5,自引:0,他引:5  
目的:研究羊膜移植治疗严重眼表面疾病的临床疗效。方法:对严重眼表面疾病29例31眼,其中急性眼烧伤炎症期6眼,陈旧性眼烧伤睑球粘连及其它眼表疾病25眼,施行单纯羊移植(15眼)和羊膜移植联合板层角膜移植术(16眼)随访3-18个月,平均8.4个月,结果:急性眼烧伤病变中4眼的炎症显著减轻。角膜未继续溶解,上皮修复;慢性病变中有20只眼的眼表面获得重建,睑球粘连得治愈或显著改善,视力不同程度提高。结论:对于急性严重的眼烧伤,羊膜移植能有效地阻止炎症和角膜溶解的发展,防止或减轻疤痕,对于陈旧性眼烧伤和其它眼表面疾病,羊膜是一种良好的生物学材料移植后能有效的重建眼表面。  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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