远程医疗在青光眼诊疗管理中的应用进展

青光眼是一种慢性进行性视神经疾病,需要长期随访监测。随着现代网络通讯技术和智能手机通讯平台的发展与普及,基于信息技术的远程医疗(telemedicine, TM)为慢性病患者提供了便捷高效的医疗服务,有利于合理利用卫生资源,降低医疗费用,提高患者满意度,近年来逐渐在慢性疾病的管理中推广应用,在青光眼诊疗管理中也有初步的应用。TM技术在青光眼领域中的应用包括疾病筛查,会诊和疾病进展监测、医学教育等3个方面。综述近年来TM在青光眼诊疗管理中的应用进展,以期为TM在青光眼全程管理中的推广和优化应用提供参考。     

互动教学在放大听力学授课中的应用

互动教学是在教学改革的进程中,在现代教学理论的指导下逐渐形成的一种先进的主体性的教学方法。有效的教学互动主要有双向、多向、网状三种模式。在放大听力学授课过程中运用互动教学方法,可提高教学质量、改善授课效果,但也应根据课程内容决定是否使用。     

互联网移动医疗平台在新生儿耳廓畸形筛查与矫治中的应用研究

目的 探讨互联网移动医疗平台在新生儿耳廓畸形筛查与矫治中的的应用效果。方法 选取解放军总医院第一医学中心2021年1月～2021年12月期间在产科分娩的新生儿为研究对象。随机分为两组,观察组(n=693)采用互联网移动医疗平台与线下健康教育相结合的方法对新生儿进行早期筛查、随诊、就诊及治疗;对照组(n=674)采用常规诊治流程与线下健康教育方法进行筛查与矫治。分析比较两组新生儿病历资料,随诊、就诊、治疗情况,以及家长认知合格率、护理满意度情况。结果 与对照组比较,观察组先天性耳廓畸形患儿按要求随诊比例更高[189例(97.4%)vs 156例(86.2%),(χ²=16.058, P<0.001)],专科就诊比例更高[158例(81.4%)vs 108例(59.7%),(χ²=21.533, P<0.001)],接受治疗比例更高[68例(35.1%)vs 22例(12.2%),(χ²=26.914, P<0.001)]。此外,观察组新生儿家长对新生儿耳廓畸形相关知识的认知合格率高于对照组[81.4%vs...     

远程睡眠医疗在阻塞性睡眠呼吸暂停低通气综合征中的应用

远程睡眠医疗是通过电子通信技术在不同地域站点间交换睡眠医学相关信息,促进患者健康的新型医疗模式,已广泛应用于失眠及白天嗜睡的患者,在阻塞性睡眠呼吸暂停低通气综合征患者中的应用已逐步开展,包括疾病监测、诊断治疗、健康教育及随访等方面,显示出良好的应用前景,在保证疗效的基础上补充患者就诊方式,减轻医疗负担。本文就远程睡眠医疗在阻塞性睡眠呼吸暂停低通气综合征中的应用现状进行综述。     

功能性近红外成像技术在听力学领域中的应用

功能性近红外成像技术（functional near-Infrared spectroscopy,fNIRS）是一种可靠的无创神经功能成像技术。因对环境要求低,被试限制小,对运动不敏感性、便携性、无声,以及对人体无损害等特点使其在临床应用和研究领域具有明显优势。近年来,fNIRS应用迅速增加,特别是神经科学领域。本文从fNIRS机制、设备分类、数据分析及优劣势方面对功能性近红外成像技术进行简介,重点讨论其在听力学领域中的应用。     

无线技术在助听器中的应用

通常人们认为声音信息的获取主要来自面对面的交谈,其实有许多重要的声音是通过其他方式获取的。听障患者有使用移动电话的需要．有知晓迅速变化信息的需要．有欣赏音乐的需要,随着无线技术和助听器技术的飞速发展．这些需要正在逐渐变为可能。     

听力学家在诊断和治疗前庭功能失调中的作用:理解和实践——美国听力学会白皮书

二十多年前笔者在美国上第一堂听力学课时，著名听力学家兼聋哑教育学家莫尔顿教授便开门见山地说“听力学家不仅能验配助听器，学会手语，同时还能为前庭失调患者提供有效的康复服务。”当时的美国，前庭失调诊断和康复还没有完全纳入听力学的职业范畴之内，仍然处于一个学科进化阶段。在本期小词典中，我们将讨论听力学家在诊断和治疗前庭功能失调中所起的作用。目前．虽然对前庭功能失调的诊断和治疗已经开始在中国各地医疗机构开展，从医学角度来看，国内对于治疗前庭功能失调的认识逐步提高，不过从临床听力学的检测来看，这个工作才刚刚开始，无论在设备还是诊断流程等方面都亟待提高和规范。本文通过介绍美国听力学会制定的对前庭功能失调的临床诊断和治疗方案，进一步阐述听力学在现代耳鼻咽喉科学中发挥的重要作用。     

烧伤湿性医疗技术在鼻内镜术后的临床应用

目的探讨烧伤湿性医疗技术对鼻内镜术后疗效的影响。方法对80例接受鼻内镜手术的慢性鼻窦炎鼻息肉的Ⅱ型2期和3期患者,按不同分期随机分为实验组（44例）和对照组（36例）,实验组鼻内镜手术后应用烧伤湿性医疗技术处理术腔,对照组应用凡士林处理术腔,术后12周、6个月及1年鼻内镜随访,观察术腔上皮化过程。结果实验组治愈41例,有效1例,无效2例,总有效率93.2%;对照组治愈30例,有效4例,无效2例,总有效率83.3%。两组术腔上皮化时间对比差异有统计学意义（P〈0.05）。结论烧伤湿性医疗技术应用于鼻内镜术后,能够明显加速术腔上皮化过程,提高手术疗效,值得临床推广。     

超细电子鼻咽喉镜在慢性咳嗽诊断中的应用

目的探讨超细电子鼻咽喉镜在慢性咳嗽诊断中的作用。方法采用Pentax VNL-1070STK型3．3mm超细电子喉镜对以慢性咳嗽为唯一主诉的223例患者进行检查,其中成人135例,儿童88例。结果223例患者均顺利接受检查,112例（50．2％）的受检查者有阳性体征,成人阳性率为42．9％（58／135）;儿童阳性率61．4％（54／88）。其中鼻、咽阳性比例最高。结论超细电子鼻咽喉镜在慢性咳嗽的诊断中有推广应用的价值。     

Consumer-directed telehealth

This article discusses consumer-directed technologies for health care and promotion in light of the rapid expansion of consumer-oriented tools and technologies, which has redefined telehealth. The difference between traditional telehealth services focused on supporting or augmenting institutional-based health care activities, and consumer-directed telehealth activities more linked to individuals are presented, the 3 orders of consumer-directed telehealth are described, and technical issues inherent in telehealth programs are discusses.     

Successful models for telehealth

Telemedicine and telehealth programs are generally more complex than their traditional on-site health care delivery counterparts. A few organizations have developed sustainable, multispecialty telemedicine programs, but single service programs, such as teleradiology and teledermatology, are common. Planning and maintaining a successful telemedicine program is challenging, and there are often barriers to developing sustainable telehealth programs. This article reviews some important aspects of developing a telehealth program, and provides two examples of currently operating successful model programs.     

Cell phones in telehealth and otolaryngology

The worldwide prevalence of mobile phones makes them a powerful platform for providing individualized health care delivered at the patient's convenience. They have the potential to extend the health care interaction from a brief office visit to a continuous monitoring via body sensors of either a specific healthcare parameter or with multiple sensors in wireless body area networks. Remote data collection by way of mobile phones in underserved areas allows for better management of public health and provides the opportunity for timely intervention. Published data showing benefits specific to otolaryngology are primarily in remote consultation, body sensors specific to balance, and appointment compliance.     

Remote hearing screenings via telehealth in a rural elementary school

PURPOSE: Telehealth (telepractice) is the provision of health care services using telecommunications. Telehealth technology typically has been employed to increase the level of health care access for consumers living in rural communities. In this way, audiologists can use telehealth to provide services in the rural school systems. This is important because school hearing screening programs are the foundation of educational audiology programs. Therefore, the goal of this study was to determine the feasibility of providing hearing screening services by telehealth technology to school-age children. METHOD: Hearing screening services-including otoscopy, pure-tone, and immittance audiometry-were conducted on 32 children in 3rd grade attending an elementary school in rural Utah. Each child received 1 screening on-site and another through telehealth procedures. RESULTS: Immittance and otoscopy results were identical for on-site and telehealth screening protocols. Five children responded differently to pure-tone stimuli presented by the telehealth protocol than by the on-site protocol. However, no statistically significant difference was found for pure-tone screening results obtained by telehealth or on-site screening procedures (binomial test, p = .37). Likewise, overall screening results obtained by traditional and telehealth procedures were not statistically significant (binomial test, p = .37). CONCLUSION: The results of this study suggest that school hearing screenings may be provided using telehealth technology. This study did find that 5 students performed differently to pure-tone screenings administered by the telehealth protocol in contrast to on-site hearing screening services. Further research is necessary to identify factors leading to false responses to pure-tone hearing screening when telehealth technology is used. In addition, telehealth hearing screening protocols should be conducted with participants of different age groups and experiencing a wide range of hearing loss to further clarify the value of telehealth technology.     

气管切开术在神经外科病人中的应用

目的 探讨气管切开术在神经外科病人中的应用.方法 回顾性分析我院2011年7月～2012年7月105例神经外科气管切开病人的临床资料.结果 本组105例均成功进行气管切开术,术后出血7例,皮下气肿4例,呼吸心跳骤停1例,切口感染2例,脱管1例,瘘口不愈合1例.无严重并发症及与手术操作有关的死亡发生.结论 气管切开术是抢救神经外科危重患者的有效措施,在积极治疗神经外科患者原发疾病同时,应尽早行气管切开术,同时娴熟手术操作及技巧的应用、加上术后良好的护理、观察,出现异常情况及时处理,气管切开术并发症就可以降低.