糖尿病与非糖尿病白内障患者散瞳后瞳孔直径的比较

目的：比较糖尿病与非糖尿病患者散瞳后瞳孔直径的大小。方法：将门诊患者分为糖尿病组和非糖尿病组，每组60例共120例。均采用美多丽眼药水给患者散瞳，30min时测量瞳孔直径。两组进行比较。结果：两组瞳孔直径大小有差异。结论：糖尿病患者散瞳后瞳孔直径明显小于非糖尿病患者。提示应重视糖尿病患者术前散瞳，确保医师按时进行手术。     

糖尿病与非糖尿病患者散瞳后瞳孔直径的比较

目的比较糖尿病与非糖尿病患者散瞳后瞳孔直径的大小.方法将门诊患者分为糖尿病组和非糖尿病组,每组60例(60只眼),共120例(120只眼).均采用复方托品酰安眼药水给予患眼散瞳,30min时测量瞳孔直径,两组进行比较.结果两组瞳孔直径大小差异有统计学意义(t=3.669,P＜0.01).结论糖尿病患者散瞳后瞳孔直径明显小于非糖尿病患者,提示应重视糖尿病患者术前散瞳,确保医师按时进行手术.     

糖尿病与非糖尿病患者散瞳后瞳孔直径的观察

目的比较糖尿病与非糖尿病患者散瞳后瞳孔直径的大小。方法将门诊散瞳患者分为糖尿病组和非糖尿病组。每组60例（60只眼）,共120例（120只眼）。均采用复方托品酰胺眼药水散瞳,30min时测量瞳孔直径,两组进行比较。结果糖尿病组散瞳时间明显长于非糖尿病组（t=2．563）,其散瞳直径明显小于非糖尿病组（t=3．669）,差异均有显著性（P〈0．01）。结论糖尿病患者散瞳后瞳孔直径明显小于非糖尿病患者,提示应重视糖尿病患者术前散瞳,以确保医师按时进行手术。     

美多丽对糖尿病性和非糖尿病性白内障散瞳效果的比较

目的：探讨使用美多丽对糖尿病性和非糖尿性白内障病人散瞳的效果，以及糖尿病性与非糖尿病性白内障病人散瞳后瞳孔直径大小的对比。方法：随机抽取40例（40只眼）糖尿病性白内障患者和40例（40只眼）非糖尿病性白内障患者，均给予患者采用美多丽散瞳，散瞳后分别在30分钟和45分钟时测量瞳孔直径大小，并进行两组比较。结果：两组散瞳后瞳孔直径大小有差异有统计学意义（T=3．621，P〈0．01）。结论：提示糖尿病性白内障患者散瞳后瞳孔直径明显小于非糖尿性白内障病患者，提示为确保手术的顺利进行，应根据糖尿病性白内障的特点进行术前散瞳。     

高龄糖尿病与非糖尿病患者眼科手术前散瞳效果的比较

目的探讨美多丽滴眼液在高龄糖尿病与高龄非糖尿病患者散瞳后效果。方法将53例高龄糖尿病患者与53例非糖尿病患者比较,共106例（106只眼）,均采用美多丽滴眼液给患者散瞳,30 min时测量瞳孔的直径。结果2组瞳孔直径大小差异有统计学意义（P〈0.01）,显示高龄糖尿病患者散瞳后瞳孔直径明显小于高龄非糖尿病患者。结论应重视高龄糖尿病患者术前的散瞳,按时手术有重要的意义。     

高龄糖尿病与非糖尿病患者眼科手术前散瞳效果的比较

目的探讨美多丽滴眼液在高龄糖尿病与高龄非糖尿病患者散瞳后效果。方法将53例高龄糖尿病患者与53例非糖尿病患者比较,共106例（106只眼）,均采用美多丽滴眼液给患者散瞳,30 min时测量瞳孔的直径。结果2组瞳孔直径大小差异有统计学意义（P〈0.01）,显示高龄糖尿病患者散瞳后瞳孔直径明显小于高龄非糖尿病患者。结论应重视高龄糖尿病患者术前的散瞳,按时手术有重要的意义。     

2型糖尿病患者散瞳结果的临床观察

目的 观察2型糖尿病患者与非糖尿病患者散瞳后瞳孔直径的大小（以下糖尿病均指2型糖尿病）。 方法 将2009年10月－2011年12月在眼科门诊就诊及因糖尿病性视网膜病变行激光治疗的住院患者30例（60只眼）纳入糖尿病组,另将因视网膜静脉阻塞、视网膜坏死综合征、视网膜裂孔等需要行视网膜激光光凝治疗的50例（61只眼）患者纳入对照组,两组均用复方托吡卡胺滴眼液散瞳,每5分钟1次,共4次,30 min后用瞳孔尺测量自然光线下瞳孔直径的大小并进行比较。 结果 在相同药物、相同时间、相同剂量的作用下,糖尿病组患者瞳孔直径变化差值较对照组小,两组比较差异有统计学意义（P＜0. 01）。 结论 糖尿病患者散瞳后瞳孔直径明显小于非糖尿病患者,在临床工作中应考虑瞳孔不易散大带来的不利因素。     

糖尿病自主神经病变病人眼底照相散瞳效果观察与意外伤害防范

目的:探讨糖尿病并发自主神经病变病人在眼底照相中的散瞳效果以及在散瞳恢复过程中减少发生意外伤害的方法。方法:将糖尿病无并发症病人与糖尿病并发自主神经病变的病人各50例进行组间比较,两组均采用复方托品酰胺眼药水给予散瞳。同时将糖尿病并发自主神经病变病人的双眼按左右眼进行自身对照,左眼1次1滴,右眼1次2滴,每5 m in 1次,共3次。从第一次给药开始计时,分别在20 m in,40 m in时用测瞳尺由同一护士测量瞳孔直径大小,并记录瞳孔散大及恢复的时间。结果:糖尿病无并发症病人与糖尿病并发自主神经病变病人瞳孔直径在散瞳后20 m in大小差异有统计学意义(P<0.01),40 m in大小差异无统计学意义(P>0.05)。加大剂量与常规剂量的瞳孔直径差异无显著性(P>0.05),而恢复时间差异性显著(P<0.01)。结论:糖尿病并发自主神经病变病人散瞳效果不佳,延长散瞳时间可增加散瞳效果。增加药物剂量对瞳孔的恢复时间影响有显著性差异,在护理上要对病人进行特别的关注。     

糖尿病视网膜病变合并白内障患者白内障术后瞳孔改变及其影响因素分析

目的 分析白内障术治疗糖尿病视网膜病变（DR）合并白内障后患者瞳孔改变及其影响因素。方法 回顾性选取2020年2月至2021年2月中国人民解放军中部战区总医院DR合并白内障超声乳化摘除联合人工晶状体植入手术患者2 000例（2 000眼）。比较不同性别、年龄、DR病程（0～5、6～10、11～15、16～20年）、糖化血红蛋白（Hb A1c）水平（≤8.4%、8.5%～13.4%、> 13.4%）、眼底荧光造影检查结果（增殖期、非增殖期）患者的术后散瞳时间和瞳孔直径,并分析术后散瞳时间和瞳孔直径与一般资料的相关性,多元Logistic回归分析术后散瞳时间和瞳孔直径的影响因素。结果 性别、年龄、Hb A1c水平与术后散瞳时间和瞳孔直径无关（P> 0.05）;糖尿病病程0～5、6～10、11～15、16～20年患者的术后散瞳时间逐渐延长,眼底荧光造影检查增殖期患者的术后散瞳时间长于非增殖期,差异均有统计学意义（P <0.05）。糖尿病病程0～5、6～10、11～15、16～20年患者的术后瞳孔直径逐渐缩短,眼底荧光造影检查增殖期患者的术后瞳孔直径短于非增殖期,差异均有统计...     

术前不同体位滴入散瞳药对老年性白内障患者散瞳效果的影响

目的 观察术前采取仰卧位、坐位滴入散瞳药对老年性白内障患者散瞳效果的影响.方法 将需行术前散瞳的老年性白内障患者240例随机分为两组,观察组和对照组各120例.观察组术前滴入散瞳药时取仰卧位,对照组取坐位头向后仰位.测量、记录患者的基线瞳孔直径、首次滴眼散瞳后30min的瞳孔直径及晶体植入前的瞳孔直径,并计算散瞳前后瞳孔直径差值、术中瞳孔达标率,进行两组间的比较.结果 最终完成本次研究的患者中,观察组102例,对照组116例.观察组首次滴入散瞳药后30min的瞳孔直径、晶体植入前的瞳孔直径及散瞳前后瞳孔直径差值均明显大于对照组(P＜0.01).观察组术中瞳孔理想达标率78.43％,基本达标率21.57％,未达标率0％;对照组术中瞳孔理想达标率56.90％,基本这标率40.52％,未达标率2.58％;两组比较,差异有统计学意义(P＜0.01).结论 老年性白内障患者术前滴入散瞳药时取仰卧位的散瞳效果优于坐位.     

Documenting diabetes care: the diabetes nurse specialists' perspective

Diabetes Nurse Specialists (DNSs) are often the hub of the communications network for the entire diabetes multiprofessional health care team, patients and their families. Frequently they liaise between primary and secondary care and have a key role in the provision of a 'seamless service'. To work effectively and efficiently they need a foolproof system of documentation and communication. The aim of the study was to investigate the means by which DNSs document patient care in order to provide baseline information about ongoing record-keeping practices. The study comprised a cross-sectional survey in which data were obtained by questionnaire. All DNSs in the UK registered with the British Diabetic Association were invited to participate in the study. A 70.3% response rate was achieved (n = 545). The results indicated that manual profession-specific records were used by 65.3% of DNSs, 21.1% used shared/integrated records, 12.8% used computerized records and only 0.7% made use of patient-held records. Whilst almost all DNSs felt that a good record-keeping system was essential in providing 'seamless care' to patients, not all felt their system was efficient. Of those using a computerized system 65.7% rated it as efficient, compared with only 28.1% of those using a profession-specific system and 26.1% of those using a manual shared system. A high percentage of DNSs (65.9%) felt that the provision of 'seamless care' was hindered by communication problems with members of other professional groups. The findings from this study indicate that computers alone cannot bridge the gap between primary and secondary care, but 'seamless care' may become more of a reality with computerized record-keeping systems and participation by all members of the multidisciplinary team.     

Cystic fibrosis-related diabetes: the presence of microvascular diabetes complications

OBJECTIVE: Cystic fibrosis (CF)-related diabetes has been regarded as a mild form of diabetes with a low risk of severe diabetes complications. The prevalence of CF-related diabetes increases with age, resulting in a 50% prevalence of diabetes at age 30 years. We sought to investigate whether microvascular complications in CF-related diabetes appear with a relevant frequency. RESEARCH DESIGN AND METHODS: Thirty-eight patients aged 30 (range 18-55) years with CF-related diabetes for 20 (0-31) years were screened for diabetes complications. Because of chronic pulmonary infections, the majority of patients were regularly treated with aminoglycoside and cyclosporine given frequently. RESULTS: Since the pharmacological treatment of lung transplant patients could influence metabolical regulation and renal function, the results are given separately for nontransplanted (n = 29) and transplanted (n = 9) CF patients. Nine patients (27%) had retinopathy, two of which had proliferative retinopathy and needed laser treatment. Lung transplantation did not affect the prevalence of retinopathy. In nontransplanted patients, nine had hypertension, three microalbuminuria, and one elevated creatinine. None had macroalbuminuria. In transplanted patients, eight of nine had hypertension, two had microalbuminuria, and none had macroalbuminuria. Seven of nine lung transplant patients had elevated plasma creatinine, and severely reduced glomerular filtration rate was significantly more frequent. CONCLUSIONS: A high frequency of diabetic retinopathy was found in patients with insulin-treated CF-related diabetes, stressing the need for a regular screening program as in type 1 diabetes. Severely impaired kidney function was common in lung transplant patients, probably secondary to cyclosporine treatment.     

Diagnosing diabetes and preventing rehospitalizations: the urban diabetes study

BACKGROUND: Patients with diabetes frequently are hospitalized, and quality of inpatient care for diabetes is of great concern. Rehospitalization after hospital discharge is a frequent adverse outcome experienced by patients with diabetes. OBJECTIVES: We assessed the frequency of and risk factors for rehospitalization among all Philadelphia residents with diabetes. METHODS: Individual histories of hospitalization were ascertained from hospital discharge summaries for Philadelphia residents ages 25-84 who had at least 1 diabetes hospitalization from 1994 through 2001. Logistic regression was used to assess predictors of nonelective rehospitalization within 30 days of discharge, including recording of diabetes diagnosis. RESULTS: Nonelective rehospitalizations within 30 days of hospital discharge were ascertained for 58,308 (20.0%) of 291,752 discharges. The proportion rehospitalized was 9.4% after a patient's first diabetes diagnosis hospitalization; after later discharges for which a diabetes diagnosis was not recorded, rehospitalizations occurred in 30.6% of all cases. The absence of a diabetes diagnosis was a highly significant predictor of rehospitalization after adjustment for age, year, gender, race/ethnicity, insurance status, admission type, severity code, length of stay, discharge status, and number of previous hospitalizations. CONCLUSION: Failure to record a diabetes diagnoses in administrative hospital discharge data may reflect lack of attention to the critical needs of patients with diabetes who are being treated for other conditions, whereas the attention to patient education and follow-up planning for patients with incident diabetes diagnoses may reduce the risk of rehospitalization.