玻璃体切割术治疗眼后段异物

目的 :探讨玻璃体切割术治疗眼后段异物的方法、时机及影响因素。方法 :对我院2000年～2003年间采用玻璃体切割术取出球内眼后段异物的38例 (38眼 )进行回顾性分析。结果 :38例患者均成功取出异物 ,术后视力提高28例 ,不变7例 ,下降3例。结论 :玻璃体手术联合眼内异物取出术治疗球内后段异物 ,可有效取出异物 ,减少并发症发生 ,恢复一定视功能。     

玻璃体切除术在后段眼内异物治疗中的应用

目的 探讨后段眼内异物的最佳手术时机和适宜的手术方案.方法 将后段眼内异物36例（36眼）的临床资料随机分成观察组和对照组,对照组采用外路磁吸术,观察组采用玻璃体切除术联合异物取出术,比较两组患者术前和术后随访6个月的最佳矫正视力.结果 外路磁吸术组异物取出率89.29％,玻璃体切除术组异物取出率100％,两组术后视力较术前均有明显改善.结论 对于后段眼内异物,外路磁吸术和玻璃体切除联合异物取出术都是有效的治疗方法,玻璃体切除术取出异物的成功率更高.     

Ⅰ期玻璃体切割术治疗后段眼内异物的临床疗效

目的评价采用I期玻璃体切割手术治疗眼后段异物的临床疗效。方法回顾性分析2008年6月-2012年1月,经I期玻璃体切割治疗眼后段异物72例,对手术前后视力、术后并发症及手术时机进行分析。结果 I期玻璃体切割异物摘出率为100.00%。术前62.50%患者视力〈0.1,术后视力≥0.1者56例（77.78%）,≥0.5者19例（26.39%）,术前术后视力比较差异有统计学意义（P〈0.05）。术后并发视网膜脱离3例,增生性玻璃体视网膜病变2例,玻璃体腔积血者1例;6例（8.33%）再次行玻璃体切割手术,术后视网膜均复位。结论 I期玻璃体切割手术治疗眼后段异物具有异物取出率高、术后视力恢复好、并发症少等优点。     

非磁性眼内异物的现代玻璃体手术治疗

目的评价现代玻璃体切除术用于眼内非磁性异物摘出的临床效果及其手术技巧。方法对采用玻璃体切除术治疗眼内非磁性异物的患者63例(68眼)进行回顾性分析。结果63例(68眼)眼内异物全部一次手术取出。9眼术前合并视网膜脱离者,术后视网膜完全复位。16眼术前合并眼内炎者,术后炎症得到控制。结论现代玻璃体切除联合眼内非磁性异物摘出手术成功率高,可同时治疗外伤所致眼内并发症。     

玻璃体腔后段悬浮锐性异物玻璃体切割术

目的 探讨玻璃体切割手术在治疗玻璃体腔后段悬浮锐性异物中的方法。方法 对明确诊断的23例玻璃体腔后段悬浮锐性异物患者,在切割玻璃体后段前首先行异物钳或手持电磁铁取出异物,然后彻底行玻璃体切割术。结果 玻璃体切割手术治疗23例玻璃体腔后段悬浮锐性异物,22例异物取出顺利,1例异物坠落导致视网膜脱离．结论 玻璃体腔后段悬浮锐性异物在切割后段玻璃体前先行异物取出,可有效避免锐性异物坠落伤及视网膜,导致医源性视网膜脱离发生。     

玻璃体漂浮异物取出53例临床分析

目的：探讨玻璃体漂浮异物的取出方法。方法：53例玻璃体漂浮异物采用三种不同的手术方法：直视下直接夹取或吸取法；显微镜下直观磁棒接力取出法；玻璃体切割联合异物取出法。结果：手术均顺利完成，未发生术中并发症，术后视力上升29例占56.6％，不变14例占26.6％；下降10例占19％。结论：玻璃体漂浮异物应根据异物磁性、大小、屈光间质透明与否而采用不同的手术方法。     

玻璃体切割球内异物取出术8例

眼球穿孔伤球内异物存留,是常见的严重致盲眼病,在现代玻璃体手术未普遍开展以前,经后路法摘出异物虽成功率已很高,但其并发症不能够同时得到恰当有效的治疗而最终失明的病例也不少。经玻璃体切除摘出异物,病人术后保存了有用视力,效果良好。现将应用玻璃体切割术取出球内异物8例治疗结果报告如下。1 临床资料     

清创缝合玻璃体切割加硅油填充治疗复杂性眼内异物

目的探讨硅油在一期清创缝合联合玻璃体切割治疗复杂性眼内异物中的临床效果。方法笔者对其所在医院收治的复杂眼内异物患者38例(38眼)进行回顾性分析。这些患者均采用一期清创缝合联合玻璃体切割行异物取出硅油填充,随访3～37个月(平均19.3个月),观察术后效果。结果异物均一次成功取出。最佳矫正视力≤0.02者10眼,>0.02者8眼,≥0.05者7眼,≥0.1者13眼。结论使用硅油填充在一期清创缝合联合玻璃体切割治疗复杂性眼内异物是安全和有效的。     

玻璃体视网膜手术治疗眼铁锈症5例分析

目的 探讨眼铁锈症的临床表现及玻璃体视网膜手术治疗的疗效.方法 5例眼铁锈症,其中4例有陈旧性眼内异物,均采用玻璃体视网膜手术取出异物;另1例是40年前以外路磁吸术取出铁质异物1枚.结果 术后1只眼视力无改变,其余4只眼视力均较术前不同程度提高.结论 眼铁锈症如果得到及时诊断,尽快取出异物和采用玻璃体视网膜手术,可以保住眼球和挽救残存视力.     

恒磁吸铁器辅助玻璃体切除术治疗眼后段磁性金属异物的临床效果

目的 评价恒磁吸铁器在玻璃体切除术中辅助眼后段磁性异物取出中的作用.方法 采用随机对照研究,将需行一期玻璃体切除联合眼内异物摘出术的45例眼后段磁性异物伤患者随机分为两组,试验组行玻璃体切除联合恒磁吸铁器辅助异物取出术(22例22眼),对照组行玻璃体切除异物取出术(23例23眼),比较两组异物脱落率、取出所需时间.结果 试验组均未发生异物脱落,经单次操作取出异物;对照组有5例异物脱落一次后取出,1例脱落两次,第三次联用恒磁吸铁器取出异物,两组异物脱落率差异有统计学意义(P=0.046).同时两组异物取出所需时间差异也差异有统计学意义(P=0.029).结论 恒磁吸铁器辅助应用于眼后段磁性异物取出术,具有方法简单、效果确切、并发症少的优点,尤其适用于较大的眼内磁性异物取出术.     

Management of lead foreign body ingestion

Previous reports of lead foreign body (PbFB) ingestion by children include two cases of lead intoxication and two cases that resulted in death. It is generally accepted, however, that PbFB ingestion does not pose a risk of lead toxicity, provided that the PbFB is not retained in the gastrointestinal (GI) tract. Recent experience with two cases substantiates this belief. On separate occasions, two 9-year old girls ingested a PbFB. The first patient developed only mild, vague GI complaints. The highest reported blood lead level (BLL) was 15 mcg/dl. The second patient did not develop symptoms, and the highest reported BLL was 22 mcg/dl. Both patients passed the PbFB in the stool within two weeks. These cases suggest that PbFB ingestions can be treated in a manner similar to other uncomplicated foreign body ingestions.     

Accidentally discovered large metallic intra-orbital foreign body

A 6.2 cm long and 2.7 cm thick metallic foreign body was accidentally found and removed from a 62 years old man. He was sent to a minor operation theater for repair of left lower lid laceration secondary to trauma after a fight. Subsequent investigation, management, patient follow-up and outcome are discussed. Importance of careful history taking, thorough physical examination and proper investigations are stressed.     

Bronchiectasis consequent upon prolonged foreign body retention

OBJECTIVE: To review our experience with bronchiectasis complicating prolonged endobronchial retention of foreign bodies (FB) among patients with a history of aspiration of FB seen between 1975 and 1998. DESIGN: A retrospective review of clinical data of consecutive patients with a history of aspiration of FB treated during the time of study. SETTING: The Cardiothoracic Unit of the University College Hospital, Ibadan, directly serves a population of about 40 to 60 million in the South Western Nigeria and the community clinics. SUBJECTS: All patients with a history of FB aspiration (or suggestive of FB aspiration) from whom patients with prolonged FB retention were selected. MAIN OUTCOME MEASURES: Patients with a relevant history or chronic respiratory symptoms had their clinical examination findings, plain chest radiographic (or/and bronchographic) findings, treatment modalities and outcome studied. RESULTS: Sixteen patients among 203 patients who had tracheobronchial foreign bodies removed had this complication. The mean age at presentation was 13.0 +/- 17.3 years. Twelve patients (75%) retained inorganic materials and in four patients (25%) it was organic. The period of retention ranged between 4.8 to 108 months (mean 17.0 +/- 22.6 months). Main presenting symptoms were: productive cough, 16 patients; pyrexia, seven patients; combination of chest pain, fever and copious sputum, five patients. In none of the patients was the history of aspiration of FB definitely elicited before commencement of treatment. Symptoms were worst among patients who retained inorganic materials. All of the patients had bronchoscopy but retrieval of FB by this means was successful in one patient (6.3%). Six patients (37.5%) had thoracotomy and bronchotomy; nine patients had bronchotomy and lung resection [seven (77.8%) lobectomies, one (11.1%) pneumonectomy and one (11.1%) segmentectomy] as the definitive treatment. The one patient who had brochoscopic retrieval subsequently had lobectomy to control symptoms of bronchiectasis. Five out of six (83.3%) who had bronchotomy had persistent symptoms of bronchiectasis. All the nine (56.3%) who had lung resection remained asymptomatic at follow up. There was one mortality (6.3%) in the series--a 75 year old who died from poorly controlled Diabetes mellitus. CONCLUSION: Prevention of aspiration of FB is better than cure. In every medically treated child with persistent cough with or without a history of aspirated FB, the possibility of retained FB should be borne in mind.     

七氟醚在小儿支气管异物术中的应用

目的 观察七氟醚在小儿支气管异物术中的麻醉效果.方法 50例支气管异物患儿随机分为观察组和对照组各25例.观察组采取七氟醚吸入麻醉;对照组采用静脉注射芬太尼复合丙泊酚麻醉.观察诱导期患儿表现,记录患儿睫毛反射消失时间、苏醒时间,监测并记录诱导前、置入支气管镜后5min的心率、SPO2和呼吸频率.结果 观察组躯体运动、屏气呛咳、喉痉挛、分泌物增多发生率均低于对照组,差异有统计学意义(P<0.05).观察组睫毛反射消失时间、苏醒时间短于对照组,差异均有统计学意义(P<0.05).置管5min时观察组心率、呼吸频率均高于诱导前,且观察组低于对照组,差异均有统计学意义(P<0.05).结论 七氟醚在小儿支气管异物术中的应用效果显著.     

七氟醚在小儿支气管异物术中的应用

目的观察七氟醚在小儿支气管异物术中的麻醉效果。方法 50例支气管异物患儿随机分为观察组和对照组各25例。观察组采取七氟醚吸入麻醉;对照组采用静脉注射芬太尼复合丙泊酚麻醉。观察诱导期患儿表现,记录患儿睫毛反射消失时间、苏醒时间,监测并记录诱导前、置入支气管镜后5min的心率、SPO2和呼吸频率。结果观察组躯体运动、屏气呛咳、喉痉挛、分泌物增多发生率均低于对照组,差异有统计学意义(P<0.05)。观察组睫毛反射消失时间、苏醒时间短于对照组,差异均有统计学意义(P<0.05)。置管5min时观察组心率、呼吸频率均高于诱导前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论七氟醚在小儿支气管异物术中的应用效果显著。     

An unusual foreign body in the oesophagus.

Unusual swallowed foreign bodies are uncommon in normal individuals. They may be encountered in the mentally deranged or the subnormal. A case of an unusual foreign body, two safety pins hooked together, in the upper oesophagus of a 27-year-old lady who looked apparently normal at the time of admission to hospital is reported. Case report: A 27-year-old lady presented with history of discomfort in the throat and difficulty in swallowing for two weeks. She denied having swallowed anything unusual. At the time of admission, she looked mentally normal, with normal behaviour. She had no signs of dehydration. There was tenderness on movement of the trachea. Indirect pharyngoscopy showed minimal pooling in the piriform fossae. Plan X-ray of the neck showed a foreign body in the upper oesophagus: two safety pins hooked together (Fig I and II). Under general anaesthesia, oesophagoscopy was carried and the foreign body was successfully removed. During oesophagoscopy, it was attempted to bring the two limbs of each safety pin together and to get the sharp end of the lower safety pin into the oesophagoscope. Fortunately, the lower safety pin broke at the joint. The upper safety pin was delivered in toto and the lower one in two pieces. The foreign body was tarnished suggesting that it stayed in the oesophagus for two weeks. Figure III shows the foreign body repositioned after removal. Post-operative recovery was uneventful and the patient was discharged home after five days in good condition. We met the patient accidentally after six months. She looked well and mentally stable.