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。     

飞行员人工晶体植入术后十年疗效观察

目的：结合1例飞行员外伤性白内障人工晶体（IOL）植入术后10年疗效的观察,探讨人工晶体植入术在民航飞行员白内障患者中的应用前景。方法：1名领航员因气枪子弹击伤右眼后引起外伤性白内障,伤后半年于1990年9月行白内障囊外摘除术并人工晶体植入术。其后进行了10年疗效跟踪观察。结果：术后1年远视力为1．0,视功能正常,1991年12月取得中国民航总局特许签发的体检合格证。1995年参加领航员改飞机驾驶专业训练,现为空中客车A－320型飞机副驾驶。截止2000年6月IOL植入术后已累计飞行4079h。结论：白内障囊外摘除联合IOL植入术用于飞行员各种原因引起的白内障的治疗,其疗效是肯定的。没有发现因手术后遗症或并发症而影响飞行安全的现象。建议对飞行员IOL植入术后视力恢复正常、视功能正常无并发症者,可由体检鉴定部门鉴定为飞行 合格,申请特许签发的体检合格证。     

表面麻醉小切口白内障摘除术在高海拔地区防盲手术中的应用

目的：探讨表面麻醉小切口白内障囊外摘除术联合人工晶体植入术在高海拔地区防盲手术应用的可行性。方法：1 206例（1 206眼）高海拔地区海拔3 000m以上地区老年性白内障患者随机分为观察组601例及对照组605例,观察组行表面麻醉小切口白内障囊外摘除联合人工晶状体植入术,而对照组采用球周麻醉进行手术。观察术中麻醉效果,对比分析术后视力及手术并发症。结果：观察组麻醉成功率99.0%,其中6例改为球周麻醉,未出现麻醉意外及全身并发症,对照组球结膜水肿61例（10.1%）,眼睑皮肤青紫淤血38例（6.3%）,球后出血7例（1.2%）,提上睑肌麻痹4例（0.7%）,差异具有统计学意义（P〈0.01）。两组术后第1天最佳矫正视力及手术中并发症差别无统计学意义（P〉0.01）。结论：表面麻醉小切口白内障囊外摘除联合人工晶状体植入术具有麻醉效果好、安全性高、适应证范围广、术后外眼美观等优点,特别适于在高海拔地区防盲手术中开展。     

小切口白内障摘除联合人工晶体植入120例临床分析

目的:分析非超声乳化小切口囊外白内障摘出人工晶状体植入术治疗白内障疗效及并发症.方法:白内障患者120例(120眼)于9点至12点角膜缘后作6～8 mm巩膜隧道切口,撕囊或截囊后以晶状体圈匙娩出晶状体核,注吸皮质植入人工晶状体.结果:术后3 d视力:12眼<0.05,68眼≥0.05～<0.3,40眼视力≥0.3;术后1mo复查时视力6眼<0.05,71眼≥0.05～<0.3,43眼≥0.3.主要并发症有角膜水肿、前房炎症反应、后囊膜破裂玻璃体脱出等.结论:白内障患者施行小切口无缝线非超声乳化白内障囊外摘除联合人工晶体植入术,手术成功率高,视力恢复良好.     

白内障囊外摘除并后房型人工晶体植入术的护理体会

手术显微镜下白内障囊外摘除合并后房型人工晶体植入术,是将浑浊的晶状体核和皮质摘出而保留后囊膜,再植入后房型人工晶体的术式。因术后不配戴眼镜,可迅速恢复视力,具有物像放大倍率小、周边视野正常等优点,目前已被越来越多的白内障患者所接受。2006年1月～2009年12月本院共施行囊外白内障摘除并后房型人工晶体植入术679例,现将护理体会报告如下。     

超声乳化白内障吸除联合人工晶体植入术联合小梁切除术治疗闭角型青光眼的临床观察

目的：评价闭角型青光眼合并白内障行晶状体超声乳化人工晶状体植入联合小粱切除术的疗效。方法：闭角型青光眼患者18例20眼,均伴有晶状体混浊,矫正视力〈0.3,行超声乳化白内障吸除联合折叠式人工晶体植入术,随访1～6个月,对手术前后视力、眼压、前房深度、前房角进行对比观察。结果：20眼患者术后眼压均控制在正常范围内,视力都有不同程度的提高。结论：超声乳化白内障吸除联合折叠式人工晶体植入术是治疗伴有晶体混浊的闭角型青光眼的有效方法。     

健康教育对小切口白内障摘除联合人工晶体植入术后患者康复的影响

目的：研究分析健康教育对小切口白内障摘除联合人工晶体植入术后患者康复的影响。方法选取治疗的小切口白内障摘除联合人工晶体植入术后患者96例患者,将其动态随机化分两组,研究组和对照组各48例。对照组患者给予常规护理,研究组患者在常规护理基础上加强健康教育,对比两组患者白内障相关知识掌握情况、护理依从性及生活质量。结果研究组患者护理后白内障相关知识掌握率（83．33％）、护理依从率（93．75％）和生活质量评分与对照组患者比较均存在明显差异,P小于0．05。结论对小切口白内障摘除联合人工晶体植入术后患者加强健康教育后效果显著,能有效提高患者白内障相关知识掌握率、护理依从率,改善患者生活质量。     

小切口白内障摘除联合人工晶体植入120例临床分析

目的：分析非超声乳化小切口囊外白内障摘出人工晶状体植入术治疗白内障疗效及并发症。方法：白内障患者120例（120眼）于9点至12点角膜缘后作6—8mm巩膜隧道切口,撕囊或截囊后以晶状体圈匙娩出晶状体核,注吸皮质植入人工晶状体。结果：术后3d视力：12眼〈0．05,68眼≥0．05～〈0．3,40眼视力≥0．3;术后1mo复查时视力6眼〈0．05,71眼≥0．05～〈0．3,43眼≥0．3。主要并发症有角膜水肿、前房炎症反应、后囊膜破裂玻璃体脱出等。结论：白内障患者施行小切口无缝线非超声乳化白内障囊外摘除联合人工晶体植入术,手术成功率高,视力恢复良好。     

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。     

白内障超声乳化术后早期视力变化与前房深度的相关性研究

目的 研究白内障术后早期视力变化与前房深度的相关性.方法 对年龄相关性白内障患者32例36眼,行3.2mm透明角膜切口白内障超声乳化吸除术联合折叠型人工晶状体植入术.分别于术前,术后1、3、7、15d检查视力,IOL-master仪测量水平角膜曲率(K1)、垂直角膜曲率(K<,2>)、角膜散光和前房深度.比较各项观察指...     

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.