超声乳化术联合房角分离术治疗闭角型青光眼合并白内障的临床观察

目的观察超声乳化术联合房角粘连分离术治疗闭角型青光眼合并白内障的临床疗效。方法将收治的61例(70眼)的闭角型青光眼合并白内障患者随机分为观察组31例(35眼)和对照组30例(35眼)。观察组患者行超声乳化白内障吸除术联合房角粘连分离术,对照组患者行超声乳化白内障吸除术联合小梁切除术。比较两组患者临床疗效及手术前和术后6个月监测视力、眼压、中央前房深度及房角宽度,并记录并发症发生情况。结果观察组患者治疗有效率97.1%显著高于对照组74.3%(P0.05);两组患者术后视力、眼压、中央前房深度及房角宽度均较手术前显著改善(均P0.05)且术后观察组患者眼压、中央前房深度及房角宽度显著优于对照组(均P0.05),两组患者术后视力无明显差异(P0.05);观察组患者术后并发症发生率(2.7%)显著低于对照组术后并发症发生率(22.9%)(P0.05)。结论超声乳化术联合房角粘连分离术治疗闭角型青光眼合并白内障疗效显著,手术安全性高,操作简易,值得临床推广应用。     

白内障超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障40例临床分析

目的：探讨白内障超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障的临床效果。方法：选取本院2012年6月-2013年2月收治的原发性闭角型青光眼合并白内障患者40例,全部患者均行白内障超声乳化吸入人工晶状体植入后联合房角分离术,术后随访1年,观察比较患者治疗前后视力、房角深度、眼压等变化情况。结果：治疗后患者的视力明显高于治疗前,眼压明显低于治疗前,且中央前房角深度较治疗前明显增加,比较差异均有统计学意义（P〈0.05）。全部患者治疗后发生角膜水肿4例,瞳孔区絮状渗出1例,经对症药物治疗3d后消失,全部未见其他并发症。结论：白内障超声乳化联合房角分离术治疗原发性闭角型青光眼合并白内障,可有效去除白内障,控制眼压,改善患者视力,值得临床推广应用。     

比较不同术式在治疗急性闭角型青光眼合并白内障中的疗效

目的 比较不同术式在治疗急性闭角型青光眼合并白内障中的疗效。方法 将2022年2-11月在本院眼科治疗的39例46眼急性闭角型青光眼合并白内障患者随机分为两组,每组23眼。对照组使用超声乳化及人工晶体植入联合小梁切除术治疗,观察组使用超声乳化及人工晶体植入联合房角分离术治疗,对比两组的临床疗效、最佳矫正视力、眼压、并发症。结果 观察组治疗有效率为95.65%,明显高于对照组的65.22%(P<0.05);两组术后1周、1个月、3个月的最佳矫正视力、眼压相比,观察组视力逐渐升高并稳定,且均高于对照组,而眼压明显降低,且均低于对照组(P<0.05);两组浅前房、前房积血、角膜水肿、黄斑水肿等并发症情况相比,观察组发生率明显低于对照组(P<0.05)。结论 超声乳化及人工晶体植入联合房角分离术治疗急性闭角型青光眼合并白内障的效果更好,能有效提升视力,降低并稳定眼压,且其并发症发生率低。     

白内障超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果

目的:观察白内障超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果。方法:选取在本院接受治疗的72例闭角型青光眼合并白内障作为研究对象,依据治疗方法不同将患者分为两组,观察组患者行房角分离术+超声乳化人工晶体植入治疗,对照组行小梁切除术+超声乳化人工晶体植入治疗。比较两组患者治疗前后的眼压和视力,前房角宽度和前房深度。结果:术前两组患者的眼压和视力,前房角宽度和前房深度比较,P>0.05,均无统计学意义,具有可比性。术后,观察组患者的眼压和视力较对照组改善更好,前房角宽度和前房深度较对照组宽度更宽、深度更深,组间P<0.05,具有统计学意义。结论:对闭角型青光眼合并白内障患者使用超声乳化人工晶体植入联合房角分离术治疗,能有效改善患者的视力和眼压,加深前房深度、开放房角,安全性好,是有效的治疗方法。     

超声乳化联合房角分离术治疗急性闭角型青光眼合并白内障的临床研究

目的:分析对于急性闭角型青光眼伴白内障患者采用超声乳化+房角分离术的治疗效果.方法:抽取2013年7月～2021年3月本院58例急性闭角型青光眼伴白内障患者,依据手术方案分组,观察组应用超声乳化+房角分离术方案治疗,对照组应用超声乳化+小梁切除术方案治疗,对比2组患者手术前后的视力、眼压与中央前房深度变化,手术治疗总有...     

超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的效果观察

目的观察超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果。方法选取我院2015年1月至2017年2月期间收治的60例闭角型青光眼合并白内障患者,随机平均分为两组。常规组采用小梁切除术+超声乳化+人工晶体植入,观察组采用房角分离术+超声乳化+人工晶体植入。观察两组患者的术后并发症情况,对比两组患者入院时及治疗后的前房深度、眼压、视力情况。结果观察组的术后并发症发生率为10.0%,显著低于常规组的20.0%(P<0.05)。入院时两组患者的前房深度、眼压、视力比较均无统计学差异(P>0.05);治疗后,两组患者的前房深度、眼压、视力均有明显改善,且观察组的前房深度、眼压、视力均明显优于常规组(P<0.05)。结论超声乳化人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障,患者的眼压明显降低,视力恢复良好。     

两种手术方式治疗闭角型青光眼和并老年性白内障的临床观察

[目的]研究两种手术方式治疗闭角型青光眼合并老年性白内障的临床疗效对比。[方法]闭角型青光眼合并老年性白内障的患者78例(85只眼),其中A组32眼因急性房角关闭合并白内障经局部及全身降眼压治疗眼压控制不佳,房角检查粘连≥180°行超声乳化白内障吸除加人工晶体植入联合小梁切除手术。B组19眼因急性房角关闭合并白内障患者经局部及全身降眼压治疗眼压控制在21mmHg以下,房角检查粘连﹤180°的眼行单纯超声乳化白内障吸除加人工晶体植入手术。C组:34只眼因慢性闭角型青光眼合并白内障,行超声乳化白内障吸除加人工晶体植入联合小梁切除手术。手术后分别对3组的视力、眼压、中央前房深度进行评估。[结果]术后所有患者视力均有不同程度提高;术后眼压控制良好84只眼,其余1只眼手术后3d眼压升高,UBM检查诊断为恶性青光眼再行玻璃体切割手术后眼压得到控制。[结论]对于发病后房角开放﹥180°的闭角型青光眼患者可单纯行白内障超声乳化摘除术及可折叠人工晶状体植入;青光眼合并白内障行联合术大多能有效的降低眼压提高视力,但是术后早期需住院观察。     

白内障乳化摘除人工晶体植入治疗闭角型青光眼临床观察

目的观察白内障超声乳化加人工晶体植入治疗原发闭角型青光眼的疗效。方法白内障超声乳化吸除人工晶体植入治疗原发闭角型青光眼31例39眼,对其手术后的视力、眼压、房角形态进行对照观察。结果（1）术后视力提高两行以上36眼;（2）术后眼压正常。3周后有2眼出现眼压升高达25～30mmHg,行小梁切除术后,眼压恢复正常;（3）术后2—3个月查UBM37眼房角均开放。结论白内障超声乳化吸除或白内障超声乳化吸除联合房角分离术能有效治疗合并白内障的原发闭角型青光眼。     

原发性急性闭角型青光眼合并白内障患者手术方法优化研究

目的手术是治疗青光眼合并白内障的主要方法。本研究对原发性闭角型青光眼合并白内障患者进行两种不同类型的青光眼白内障联合手术,以比较两者的治疗效果,筛选最佳治疗方法。方法回顾性分析2015-12-01-2017-12-01收治的原发性急性闭角型青光眼合并白内障患者资料,依照年龄、性别和眼压基础值对两组进行匹配,删除不能匹配的患者,最终确定可以匹配的120例患者作为研究对象。接受白内障超声乳化吸出+人工晶体植入联合房角分离术治疗的58例患者作为观察组,接受白内障超声乳化吸出+人工晶体植入联合小梁切除术的62例患者作为对照组。比较两组视力、眼压和并发症情况。两组手术前后视力及眼压变化的比较采用双因素重复测量方差分析,并发症发生率的比较采用Fisher确切概率法。结果对照组术前视力为0. 22±0. 05,术后视力为0. 51±0. 12,观察组术前视力为0. 22±0. 05,术后视力为0. 59±0. 12,差异有统计学意义,F_(组间)=1. 031,P=0. 047,F_(时间)=7. 385,P 0. 001。对照组术前眼压为(38. 20±7. 04) mm Hg,术后眼压为(25. 85±7. 18) mm Hg,观察组术前眼压为(38. 25±10. 74) mm Hg,术后眼压为(18.20±7. 61) mm Hg,差异具有统计学意义,F_(组间)=1. 169,P=0. 003,F时间=2. 433,P 0. 001。对照组并发症总发生率为27. 42%,高于观察组的10. 34%,差异有统计学意义,P 0. 05。结论白内障超声乳化吸出+人工晶体植入联合房角分离术可有效改善前房结构,降低术后并发症发生率。     

超声乳化吸除联合房角分离术治疗急性原发闭角型青光眼合并白内障的临床效果观察

目的探讨超声乳化吸除联合房角分离术治疗急性原发闭角型青光眼合并白内障的临床治疗效果。方法选取2013年11月—2014年10月来本院进行治疗的急性原发闭角型青光眼合并白内障患者36例,患者均采用乳化吸除联合房角分离术进行治疗,将术后患者相关的临床症状与术前进行比较,观察并发症情况。计量资料采用配对t检验,P0.05为差异有统计学意义。结果患者手术后眼内压(14.47±2.18)mm Hg(1 mm Hg=0.133k Pa)、前房深度(4.09±0.12)mm、眼房角开放角度(73.24±9.45)°、视力情况(0.73±0.24)°均优于术前[(36.24±2.14)mm Hg、(2.09±0.14)mm、(196.54±9.52)、(0.17±0.01)°],差异均有统计学意义(t=42.16、64.17、54.38、13.79,均P0.05)。结论超声乳化吸除联合房角分离术治疗急性原发闭角型青光眼合并白内障具有较高的安全性,可以改善患者的临床症状,提高患者的生活质量,具有极强的临床应用价值,值得推广使用。     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Ending clinical relationships with people with schizophrenia

The potential for the social worker-client relationship to contribute to therapeutic outcomes is not always apparent with clients who have schizophrenia. Their cognitive impairments often make it difficult for these clients to regulate interpersonal boundaries and for social workers to connect with them. Clinical practice is enhanced, however, by recognizing that severely impaired clients have the capacity and desire for relationships with service providers and others. The manner in which the clinical relationship ends is important for maintaining clinical gains and determining whether the client will risk investing in future relationships. The purpose of this article has been to sensitize social workers to the delicate nature of managing the endings of those relationships.