麻醉机强制通气频率和吸呼比的质控方法研究

目的:通过分析强制通气频率和吸呼比在设定参考点之间的变化关系,判断强制通气频率和吸呼比在质控中的意义,指导质量控制工作的开展。方法:采集全院近30台麻醉机3 a质控工作所得强制通气频率和吸呼比数据,运用统计学方法进行实际与理论值的对比分析。结果:强制通气频率不合格率非常低,与设定点的吻合度非常高;吸呼比在麻醉机质控中波动范围较大。结论:在质控工作中,吸呼比的检测工作应和潮气量等关键参数一样放到重点位置进行检测分析;而强制通气频率在麻醉机安全性上不合格率极低,没有决定性的作用,降低其在质控中的工作比重,主观不定时地观察或随机抽查即可。     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

过氟化碳液体在玻璃体切除术中的应用

目的 探讨过氧化碳液化（Liquid perfluorocarbon,LPFC)在玻璃体切除术中的应用。方法 应用LPFC在玻璃体切除术中打开视网膜漏斗、翻转视网膜巨大裂孔的后瓣、稳定视网膜后剥除视网膜前膜及眼内激光等,对40例患者临床资料进行分析。结果 所有患者视网膜均复位。结论 LPFC作为“流动的液体操作工具”应用于玻璃体切除手术中可改善手术操作。提高手术效率。     

西藏地区影响老年性白内障术后视力改善因素分析

目的 分析影响西藏地区老年性白内障术后视力改善的因素.方法 对西藏地区接受白内障手术的老年性白内障278例,分析年龄、核分级、术式(超声乳化术和小切口白内障囊外摘除术)、人工晶状体度数、角膜水肿部位等对术后视力改善的影响.视力采用LogMAR视力.统计方法分别采用单因素和多因素线性回归方法.结果 (1)单因素分析:术式:超声乳化术组术后较术前视力改善(平均视力差) 0.92±0.48,小切口白内障囊外摘除术组平均视力差0.83±0.46,两种手术方式对视力改善的影响,差异没有统计学意义(P＞0.05).年龄:70-、80-年龄组分别与40-、50-、60-年龄组差异有统计学意义(P＜0.05).角膜水肿部位:弥漫性水肿(平均视力差0.52±0.42)较中央部位水肿(平均视力差0.70±0.44))对视力改善影响更大,差异有统计学意义(P＜0.05).(2)多因素线性回归分析:年龄、角膜水肿部位均对视力改善有影响,差异有统计学意义(P＜0.05).结论 (1)超声乳化术和小切口白内障囊外摘除术两种手术方式对视力提高程度无明显差异,因此在西藏地区可以根据当地条件,包括经济状况和医师具备的手术水平,来选择术式,以使患者获得最佳有用视力.(2)年龄为白内障术后视力改善的影响因素之一,随年龄增加视力改善减少,而西藏地区就医条件有限,故在西藏地区更应重视白内障的普查,强调早期发现和早期手术.(3)在角膜水肿分级无明显差异的基础上,弥漫性水肿较中央部水肿对视力改善影响更大,因此在术中应谨慎操作,尽量避免角膜内皮广泛的损伤.     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

大鼠角膜缘移植后角膜缘上皮中RANTES和MCP-1表达的意义

目的:研究RANTES和MCP-1在大鼠角膜缘移植模型中的动态表达,探讨其与移植排斥反应发生的关系. 方法:将大鼠随机分为同种异体移植组(AG组)、自体移植组(SG组),并以健康大鼠作为正常对照组(N组),用定量竞争性RT-PCR的方法,在术后(POD)1, 4, 7, 11, 14, 21和30 d分别检测各组大鼠RANTES和MCP-1 mRNA的含量,并观察大鼠眼表变化,判断排斥反应的发生. 结果:术后5 d开始AG组出现排斥反应,8~10 d达到高峰. RANTES和MCP-1 mRNA含量术后均大幅增加(P<0.05),RANTES于POD7达峰,MCP-1于POD11达峰,随后均持续下降. POD1, 4 AG组与SG组RANTES与MCP-1 mRNA含量无差异,POD7～30均有明显差异. 结论:动态检测RANTES和MCP-1 mRNA含量,可能有助于临床上对角膜缘移植排斥的诊断和对预后的估计.     

眼痒难耐怎么办

眼部瘙痒是眼科门诊最常见的主诉之一，眼部瘙痒的原因多种多样，如果治疗不当会导致病变迁延不愈，甚至加重症状。     

毒性眼前节综合征临床特征的分析

目的 探讨毒性前节综合征(TASS)的发病原因、临床表现、治疗方法及预后.方法 本研究为系列病例研究,回顾性分析8例TASS患者的临床资料.结果 7例为白内障术后、1例为角膜穿通伤术后病例.发病原因:3例因手术器械碘伏浸泡后未冲洗干净而发生,2例因白内障术中灌注液误用蒸馏水而发生,2例因术毕时结膜下注药反流进入前房而发牛,1例因术后前房注药误用注射用水配制而发生.发病时间:3例在手术中发病,5例在术后1 d发病.8例均有无痛性视物模糊(100%).术巾发生的3例均表现为角膜透明性降低,虹膜大量脱色素.术后1 d时,8例患者均表现为弥漫的角膜基质水肿和严重的前葡萄膜炎.所有病例均给于0.1%地塞米松或1%醋酸泼尼松滴眼液滴眼,4次/d至1次/h.眼压升高的患者加用2%卡替洛尔滴眼液,2次/d.预后:2例患者发生角膜内皮失代偿,6例角膜恢复透明.结论各种毒性物质误入前房可导致TASS,这些情况都是可以避免的.早期诊断和正确治疗可能会改善预后.(中华眼科杂志,2009,45:225-228)     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

目的 探讨白内障手术初学者超声乳化吸除术和囊外摘除术,学习曲线特点及学习过程中同玻璃体脱出相关的危险因素.方法 回顾分析作者最初的连续350例超声乳化手术和350例囊外摘除手术经过,并分析手术患者性别、年龄、眼别、白内障类型、人工晶状体度数、撕囊是否成功、患者是否配合等因素对玻璃体脱出的影响.结果 各因素对囊外摘除手术玻璃体脱出发生率均无影响,白内障类型、人工晶状体度数、撕囊是否成功对超声乳化手术玻璃体脱出率有影响,其中IV级核、撕囊不成功、IOL度数≥24.5、Ⅰ级核及IOL度数≤15.0等5个因素是玻璃体脱出的危险因素,Ⅱ级核是保护因素(P<0.05).结论 超声乳化手术较囊外摘除手术受患者条件影响更大,初学者宜选取正视眼、Ⅱ级核、相对年轻的患者并在撕囊成功的前提下进行超声乳化手术的学习.