外伤性白内障56例手术治疗分析

目的探讨外伤性白内障手术治疗时机,术式选择及其效果。方法总结我院2007年4月~2008年6月收治的外伤性白内障56例,分别采用白内障一期和二期摘除、人工晶体一期或二期植入术共56眼,对其效果进行分析。结果本组56眼术前视力光感～0.1,术后3个月矫正视力〈0.05者4例（7.1%）,0.05～〈0.3者9例（16.1%）,0.3～0.6者31例（55.4%）,〉0.6者12例（21.4%）。手术脱盲率为92.9%,脱残率76.8%。结论选择正确的手术时机、手术方式及积极处理术中、术后并发症是治疗外伤性白内障的关键。     

弹性前房型人工晶体植入术25眼

１９９６年以来,我院行前房型人工晶体植入术２５眼,经过２年的随访观察,手术效果较好。１临床资料１．１一般情况本组男１６眼,女９眼;年龄２１～７６岁。平均５９．８岁。术前诊断：老年性白内障９眼,外伤性白内障７眼,并发性白内障２眼,无晶体５眼,膜性白内障１眼,人工晶体脱位１眼。术前检查：房角均正常,眼压 １４．５７～２０．５５ ｍｍＨｇ,前房轴深＞２．５ ｍｍ,角膜平均直径 １２ ｍｍ。１．２手术方式一期前房型人工晶体植入１８眼,白内障囊外摘除７眼,超声乳化白内障摘除４眼,外伤性白内障摘除７眼,其中３眼…     

囊袋张力环植入治疗外伤性晶状体脱位

目的探讨囊袋张力环(CTR)在外伤性晶状体悬韧带断裂的白内障手术中的植入时机。方法对24例(25眼)外伤性晶状体悬韧带部分断裂的患者行白内障手术,术中连续环形撕囊,行白内障超声乳化吸除后,囊袋内植入CTR及后房型人工晶状体。术后随访6个月～4年。结果术中无悬韧带断裂范围扩大,白内障皮质注吸干净。术后1个月矫正视力≤0.4者6眼,0.5～0.9者16眼,≥1.0者3眼。术后6个月散瞳检查,25眼的人工晶状体均处于正位,无倾斜及明显偏位。未见CTR引起的并发症。结论CTR应用于外伤性晶状体悬韧带断裂的白内障患者,利于人工晶状体囊袋内植入,有效防止术后人工晶状体偏位的发生。白内障超声乳化吸除后植入CTR利于术中操作,更安全可靠。     

高龄老年性白内障67例诊治探讨

目的：探讨高龄白内障患者的治疗特点。方法：回顾分析经治疗筛选后无手术禁忌证的67例（72眼）高龄白内障患者的相关临床资料。术前、术后对患者局部及全身进行综合检查及治疗;术中在持续低流量吸氧和心电监护下采用表面麻醉,软壳技术,居中环形撕囊的小切口白内障摘除人工晶状体植入术;随访1～12个月。结果：术后1周最佳矫正视力〈0.05者（4眼）,≥0.05而〈0.3者12例（12眼）,0.3以上者51例（56眼）。术前与术后1周最佳矫正视力差异有统计学意义（P〈0.05）。手术脱残率77.8%,脱盲率94.4%。术中后囊破裂5例（5眼）,术后角膜水肿16例（17眼）。结论：高龄白内障患者的治疗应优先选择小切口白内障摘除人工晶体植入术。仔细全面的术前、术中及术后全身因素及局部的个体化治疗,可降低手术风险,确保手术安全顺利进行。     

三种手术方法治疗白内障继发青光眼的疗效比较

目的：探讨膨胀期白内障继发青光眼手术方法及其疗效。方法：回顾性分析2004-02～2010-06诊治的43例膨胀期白内障继发青光眼手术后的临床资料和随诊结果,依据病人病史、术前眼压控制情况及查体所见分别行：①白内障现代囊外摘除（ECCE）、人工晶体（IOL）植入联合小梁切除术;②超声乳化白内障吸除（Phaco）、人工晶体（IOL）植入联合小梁切除术;③单纯超声乳化白内障吸除人工晶体植入术三种手术方式。43例病人术后随访12-48个月。结果：术后视力〉0.3者38例,43例病人无一例继发恶性青光眼,术后眼压控制在正常范围。结论：膨胀期白内障应首选晶体摘除和人工晶体植入,选择正确的手术方式,是减少术后并发症,促进术后视功能恢复的关键。     

前部玻璃体切割术在眼前节手术中的应用

 目的 研究前部玻璃体切割术在复杂前节手术中的作用.方法 回顾性研究应用前部玻璃体切割术处理复杂前节手术并发症151例(151眼),均经角巩膜缘隧道切口行前部玻璃体切割,手术后定期复查患眼视力、最佳矫正视力,前节反应情况与人工晶体位置,玻璃体视网膜情况.结果 62服超声乳化术中后囊破裂经前部玻璃体切割处理均Ⅰ期植入后房型人工晶状体,最佳视力0.3～0.5者19例(19/62,30.64%),0.5～0.8者32例(51.61%,32/62),0.8以上11例(11/62,17.78%),16眼儿童后发性白内障经前部玻璃体切割处理11(11/16,68.75%)例视力提高,4例后发障复发(4/16,25%).前部玻璃体切割处理外伤性白内障,伴后囊破裂54例,49例(49/54,90.74%)植入人工晶状体,最佳视力0.1以下者3例(3/49,5.56%),0.1～0.3者6例(6/49,11.12%),0.3～0.5者17例(17/49,31.48%),0.5～0.8者15例(15/49,27.59%),0.8以上者8例(8/49,14.81%),伴中、重度晶状体脱位13例,均植入人工晶状体,视力0.1以下者2例(2/13,15.38%),0.1～0.3者3例(3/13,23.08%),0.3～0.8者7例(7/13,53.84%),0.8以上者1例(1/13,7.69%).结论 前部玻璃体切割手术在处理复杂的前节手术及并发症方面具有一定的优越性.     

准分子激光原位角膜磨镶术矫治白内障人工晶体植入术后残存屈光不正的效果

目的 探讨准分子激光原位角膜磨镶术(LASIK)对白内障人工晶体植入术后屈光不正的矫治效果.方法 对各种原因引起的白内障人工晶体植入术后随访病情稳定时间超过2年的屈光不正患者58例(66只眼)行LASIK,术后随访时间12个月以上.观察视力、屈光状态、角膜地形图情况.结果 56只眼(84.8%)LASIK术后视力均达到或超过术前的最佳矫正视力,10只眼(15.2%)LASIK术后最佳矫正视力下降1～2行.结论 LASIK是矫治白内障摘除人工晶体植入术后屈光不正的安全、有效的方法.严格掌握手术适应证和手术时机是手术成功的关键.     

微梯形切口水冲核法在白内障囊外摘除术中的应用

目的：探讨非超声乳化白内障囊外摘除联合人工晶体植入手术方法。方法：对342眼患者采用微梯形切口水冲核方法摘除白内障联合人工晶体植入手术。结果：术后1周裸眼或矫正视力〈0.5者101眼,0.5~0.8者167眼,〉0.8者74眼。术后1个月裸眼或矫正视力〈0.5者76眼,0.5~0.8者120眼,〉0.8者146眼。平均角膜散光度为0.75~1.25D。角膜水肿者25眼,于术后2~7 d消褪。后囊膜破裂26眼,术中5眼行前部玻切。结论：手术操作简单,切口小、散光小、视力恢复快。适应证广,并发症少,是一种简便易学、投资设备少、费用低、疗效肯定的手术方法。     

人工晶体悬吊术37例手术体会

phaco术、白内障囊外摘除及人工晶体植入手术是白内障患者的主要治疗手段，但一些外伤性白内障合并后囊破裂、晶状体脱位、白内障术时后囊膜巨大破口合并玻璃体脱出，不能行1期后房型人工晶体植入术病人，可以行人工晶体悬吊术。笔者自2002年9月～2005年5月共施行人工晶体悬吊术37例，效果满意，现报告如下。     

超声乳化摘除术治疗高度近视白内障24例疗效观察

目的:评价高度近视白内障超声乳化摘除术的疗效.方法:对24例(29只眼)混合性、并发性白内障施行超声乳化吸除,通过4.0 mm切口植入后房型人工晶体.平均年龄63.8岁(38～80岁).结果:术后1周裸眼或矫正视力≥0.4者,占73.7%,术后3月为84.2%.结论:高度近视白内障超声乳化及后房型人工晶体植入术,具有术后视力恢复快且稳定等优点,但高度近视并发玻璃体及视网膜疾病者,视力恢复较差.     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.