Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

贯叶金丝桃治疗膝关节骨性关节炎的临床研究

目的:探讨贯叶金丝桃治疗膝关节骨性关节炎的临床疗效。方法:我院2009年5月~2010年5月收治膝关节骨性关节炎患者180例,随机分为2组,每组90例。治疗组给予口服贯叶金丝桃制剂,对照组给予口服盐酸氨基葡萄糖片。结果:治疗组和对照组的临床症状均有明显改善,治疗组总有效率达92.2%,对照组总有效率为91.1%,2组疗效比较差异无统计学意义(P0.05)。结论:贯叶金丝桃片是治疗膝关节骨性关节炎的一种有效方法。     

手法劈核治疗老年性白内障

目的观察手法劈核治疗老年性白内障的临床效果。方法对98例（107眼）老年性白内障行手法劈核,植入硬性人工晶体,术后3个月内观察视力、角膜散光度变化及手术并发症。结果术后第1周视力大于等于0.5者76眼（71.03%）,0.8-1.0者20眼（22.47%）。角膜平均散光度术后3个月与术前比较差异无统计学意义（P〉0.05）,术中4眼出现后囊膜破裂（3.74%）。结论手法劈核治疗老年性白内障术后视力恢复好,手术方法简单且安全有效。     

350-mm2Baerveldt青光眼引流管植入术治疗合并人工晶体植入后的难治性青光眼

目的 评价350-mm2Baerveldt青光眼引流管植入术治疗合并人工晶体植入后的难治性青光眼的疗效.方法 回顾性研究了2000年6月到2004年5月,在新加坡国立眼科中心32例33眼350-mm2Baerveldt青光眼引流管植入术治疗合并人工晶体植入术后的难治性青光眼,手术成功的标准定为眼压大于等于6 mmHg同时小于等于21 mmHg(1 kPa=7.5 mmHg),必要时用抗青光眼药物,手术失败的标准定为眼压小于6 mmHg或大于21 mmHg,再次行抗青光眼手术或视力光感消失.结果 术后平均随访时间为30.78 m±15.34 m(14-49)m,平均眼压从术前32.30±7.52(23-50)mmHg,到术后最终随访时间15.41±5.85(5-25)mmHg(P＜0.001)下降52.29%.完全成功眼压大于等于6 mmHg和小于等于21 mmHg且不用抗青光眼药物,最终随访时为51.52%,部分成功率上述相同眼压条件但加用抗青光眼药物为24.24%.手术后最终随访视力提高或不变者为16眼,占48.48%,20眼占60.60%无术中术后并发症,8眼手术后出现暂时性前房出血,3眼出现低眼压合并浅前房,其中2眼出现渗出性脉络膜脱离,2眼最后出现大泡性角膜病变,1眼引流管蚀出,1眼视力光感消失.结论 350-mm2Baerveldt青光眼引流管植入物在治疗合并人工晶体植入术后的难治性青光眼中,大部分患者能有效的降低眼压,并且出现较少的严重手术并发症.     

活血化瘀益气方治疗肾综合征出血热52例

肾综合征出血热(hemerrhagic fever with renal syndrome,HFRS)是汉坦病毒(Hantaan virus,HV)引起的自然疫源性传染病.临床以发热、低血压休克、出血、肾脏功能损害为主要特征.该病广泛流行于亚洲、欧洲许多国家.我国为重疫区,其对人类健康的危害性极大.笔者自1991年6月以来应用活血化瘀益气法为主,随症加减治疗该病52例,并与常规病毒唑、平衡盐液等治疗的30例作对比,临床疗效满意,现报告如下.     

椎动脉沟注射治疗椎动脉型颈椎病及其机理的研究

目的:观察椎动脉沟注射治疗椎动脉型颈椎病(中医辨证属于气血不足)的临床疗效及其安全性.方法:180例患者通过随机、开放、阳性药物对照试验的方法进行临床试验.其中治疗组90例,对照组90例.30天为1个疗程.1个疗程结束后评定近期疗效.治疗组进行椎动脉沟注射,对照组口服颈复康颗粒.结果:2组治疗前临床症状及体征的积分比较差异无统计学意义(P＞0.05);治疗组总有效率为92.2%,对照组总有效率为91.1%,治疗后2组疗效比较差异无统计学意义(P＞0.05).两组治疗后椎-基底动脉血流速度分别快于治疗前,治疗前后血流速度比较差异有统计学意义(P＜0.05).结论:椎动脉沟注射能明显改善患者的主要临床症状、体征及椎-基底动脉血流速度,治疗椎动脉型颈椎病的临床疗效及改善椎-基底动脉血流速度与对照组相当.可用于治疗椎动脉型颈颈椎病.     

盘龙七片治疗急慢性软组织损伤的近期疗效分析

目的:观察盘龙七片治疗急、慢性软组织损伤的近期疗效。方法:将700例急、慢性软组织损伤的患者随机分为治疗组和对照组,治疗组360例,口服盘龙七片治疗;对照组340例,用舒筋活血汤口服治疗,10天为一个疗程。一个疗程结束后评定近期疗效。结果:两组治疗前疼痛、肿胀、压痛、功能受限等积分差异无显著性意义(P>0.05);治疗后两组在功能受限等体征方面差异有显著性意义(P<0.05),在疼痛、肿胀等症状和压痛等体征方面的差异有非常显著性意义(P<0.01);两组近期疗效评价差有异显著性(P<0.01)。结论:盘龙七片是治疗急、慢性软组织损伤的有效药物。     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

2型糖尿病患者代谢指标与认知障碍的关系

目的 探讨 2型糖尿病(T2DM )患者认知功能水平与血糖(Glu )、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、胰岛素(Ins)水平等代谢指标之间的关系.方法 选取50例T2DM患者为T2DM组 ,47例年龄、性别构成比、文化程度、职业等方面相匹配的健康人作为对照组.应用多维度神经认知量表(连线测验、MoCA量表、数字广度测试、健康调查表)分别对两组人群进行认知功能检测 ,并将T2DM患者的认知功能评分与Glu、HbA1c、HOMA-IR、Ins水平进行相关性分析.结果 T2DM组的发散思维能力、短时记忆、空间与执行能力、注意能力、语言、抽象、延迟回忆、定向能力均低于对照组(P＜0 .05);焦虑、抑郁情绪重于对照组(P＜0 .05).多因素线性逐步回归分析结果显示 ,在年龄、病程、教育程度、吸烟指数、血压、血脂作为混杂因素校正的情况下 , Glu、HbA1c、HOMA-IR、体重指数(BMI)、Ins是导致认知功能评分下降的危险因素(P＜0 .05).结论 T2DM患者认知功能减退 ,且Glu、HbA1c、HOMA-IR、BMI、Ins水平与认知功能减退呈明显的正相关性.