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.     

利多卡因局麻致严重并发症2例报告

我们在行白内障手术局麻时遇见严重并发症 2例 ,经抢救治愈、死亡各 1例。现报告如下。例 1:女 ,6 8岁。老年性白内障。体检 :一般情况可。HR76次 /min,R18次 /min,Bp15 0 /10 0 mm Hg(19.9/13.3k Pa)。心电图示慢性冠状动供血不足。血常规、出凝血时间、尿常规、肝肾功能均正常。既往无糖尿病史。2 0年前曾行阑尾切除术 ,有高血压病史 10余年 ,无药物过敏史。入院后经术前准备及降血压 ,拟行白内障囊外摘除人工晶体植入术。术前用 2 %利多卡因 3.5～ 4ml行球后及面神经阻滞麻醉。在软化眼球时 ,患者出现烦躁 ,开始手术后 2 0分钟 ,患者…     

腰痛宁胶囊治疗腰肌纤维炎多中心临床试验研究

目的评价腰痛宁胶囊治疗腰肌纤维炎(寒湿瘀阻证)的临床有效性及安全性。方法采用随机、盲法、安慰剂平行对照、多中心临床试验方法,总病例数144例,其中治疗组72例,服腰痛宁胶囊;对照组72例,服用腰痛宁胶囊安慰剂。1个疗程即连续用药14 d后评价临床疗效及安全性。结果全分析集(FAS)分析显示,治疗组临床控制+显效例数之和与总例数的比值(控显率)优于对照组(P0.001),符合方案集(PPS)分析显示治疗组控显率优于对照组(P0.001);FAS分析显示,治疗组疼痛改善优于对照组(P0.001),PPS分析显示治疗组疼痛改善优于对照组(P0.001)。本试验共发生不良事件3例(2.10%),均发生在对照组,治疗组未发生不良事件,组间不良事件发生率无统计学差异(例数/例次P=0.245)。结论腰痛宁胶囊治疗腰肌纤维炎(寒湿瘀阻证)疗效确切,明显优于安慰剂,试验中未发现严重不良反应,安全性较好。     

小光区放射状角膜切开术临床应用

参考WilliamEllis公式,采用2.75mm小光区对-6.00～-13.OOD近视者施术。术后对33眼随访3～20个月,并与随机分组同期手术的30眼-6.00～-13.OOD的3mm光区手术组进行比较,结果27.5mm光区组的近视矫正量平均为-7.33±1.11D,3mm光区组平均为-6.05D±0.92D。两组术后均无明显眩光表现。认为2.75mm光区RK手术可明显提高近视矫正量(P<0.001)。     

微切口冷超声乳化白内障摘除折叠式人工晶体植入术探讨

目的探讨2mm微切口冷超声乳化白内障摘除术技术及可行性,评价其临床疗效。方法我们对86例(117只[)老年性白内障施行了双切口冷超声乳化白内障摘除并2mm微切口折叠人工晶体植入术。对灌注劈核器进行了相应改造,对超声乳化仪技术参数进行了筛选调整。于3点和11点方位角巩膜缘分别行1.2mm×1.2mm、1.5mm×1.2mm切口,灌注劈核器、超声乳化无套管探头分别通过双切口进入前房,超声能量采用间歇释放/强度线性调整模式,采用快速劈裂法乳化核组织,扩大切口至2mm植入折叠式人工晶体。观察手术中超声能量应用情况、乳化时间、术中术后并发症,追踪观察术后视力及散光情况。结果超声能量和乳化时间:核硬度为II级者平均应用能量(3%)/平均乳化时间为(0.57±0.37)min;III级核平均应用能量(8%)/平均乳化时间为(068±0.58)min;IV级核平均应用能量(11%)/平均乳化时间为(1.35±0.95)min。术后首日裸[视力≥0.5者占94.3%,≥1.0者占40.5%;术后一周,平均散光(0.76±0.59)D,与术前散光比较无显著性差异(p>0.05)。117只[中,9只[(7.7%)术后切口周围浸润水肿,1-2天后恢复透明,无角膜切口灼伤、严重水肿、后囊破裂、切口漏液、前房异常等并发症。结论微切口冷超声乳化白内障摘除手术具有良好的临床疗效,为更新人工晶体的研发奠定了基础。具有临床的可操作性和开拓价值。     

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.     

Bimanual微切口白内障摘除术的临床研究

目的 对Bimanual微切口白内障摘除技术及可行性进行研究和探讨,客观评价其临床疗效.方法 对Bimanual(双手操作)微切121超声乳化(A组),观察超声能量、乳化时间和术后散光,并与常规超声乳化手术(B组)进行比较.结果 A组超声能量和乳化时间:核硬度为Ⅱ级者平均应用能量3.9%、平均乳化时间为(0.56±0.40)min;Ⅲ级核者平均应用能量8.3%、平均乳化时间为(0.65±0.58);Ⅳ级核者平均应用能量12%、平均乳化时间为(1.35±0.82)min.术后首日裸眼视力≥0.5者占95.8%,≥1.0者占39.8%.无角膜切口灼伤、切口漏液、前房异常等并发症.术后7d:A组平均手术性散光为(0.42±0.55)D,B组平均手术性散光(1.26±1.14)D,术后3个月:A组平均手术性散光为(0.35±0.25)D,B组平均手术性散光(0.87±0.62)D,两组散光变化差异均有统计学意义.结论 Bimanual微切121超声乳化白内障摘除手术具有稳定良好的临床疗效,具有切口微小等技术优势,具有很好的临床前景.     

硬核白内障摘出手术中水平手法劈核的效果

目的评价水平手法劈核治疗老年性硬核白内障摘出手术中应用的效果及安全性。方法对89例（89眼）老年性白内障摘出手术,核硬度Ⅲ级至Ⅳ级行水平手法劈核,植入硬性人工晶状体,术后3个月内观察视力、角膜散光度及手术并发症。结果术后第1周视力≥0．5者63眼（70．78％）,0．8—1．0者18眼（20．22％）。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）,3眼出现后囊破裂（3．37％）,无术后感染或角膜内皮失代偿等严重并发症。结论水平手法劈核用于硬核白内障摘出手术,术后视力恢复好,手术方法简单、安全。