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101.
Tube shunt implantation is a common procedure for control of intraocular pressure (IOP). However, tube revision and repositioning must sometimes be performed, and this involves removing the tube from its sclerostomy site. This site is prone to leaking and this may cause postoperative hypotony. We describe a novel and cosmetically acceptable technique of plugging and covering the sclerostomy site with gamma-irradiated corneal tissue. 相似文献
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103.
目的 探讨中心静脉导管胸腔闭式引流术在外伤性血气胸患者的临床疗效及护理体会.方法 对62例外伤性血气胸的患者采用中心静脉导管胸腔闭式引流法治疗血气胸,护理并观察患者疗效及并发症.结果 本组病例患者疼痛少,引流口创伤小、愈合佳,血气胸吸收满意.结论 中心静脉导管胸腔闭式引流术对外伤性血气胸的治疗有积极的作用,可减轻患者的痛苦,利于血气胸吸收,缩短住院时间,值得临床推广. 相似文献
104.
术前急诊钻颅引流对重型颅脑创伤脑疝患者颅内压、脑组织氧分压及其预后的影响研究 总被引:4,自引:2,他引:4
目的监测钻颅引流前后颅内压(ICP)、脑组织氧分压(PbtO2),探讨术前急诊钻颅引流在重型颅脑创伤脑疝患者中应用的临床价值。方法按脑创伤脑疝类型分为单瞳散大组42例,双瞳散大组34例,均在开颅前行急诊钻颅引流术,并同时在非损伤侧额叶脑组织内先置人ICP、PbtO2探头,连续监测并记录钻颅引流前后的ICP、PbtO2。结果钻颅引流能降低ICP,提高PPbtO2,两组与术前比较差异均有非常显著意义(P〈0.001)。治疗结果:良好/中残,单瞳散大组36例(78.57%),双瞳散大组16例(44.12%);重残/长期昏迷:单瞳散大组1例(7.14%),双瞳散大组8例(26.47%);死亡:单瞳散大组7例(14.29%).双瞳散大组15例(44.12%)。结论术前急诊钻颅引流术能有效降低ICP和提高PbtO2,改善脑疝症状,缩短脑疝时限,延长脑创伤脑疝患者的手术治疗时间窗,对于提高重型颅脑创伤脑疝患者的治愈率,降低死亡率和致残率,具有较高的临床应用价值。 相似文献
105.
目的 观察益气活血消肿汤治疗乳腺癌术后上肢淋巴水肿(BCRL)气虚血瘀、水湿停聚证的临床疗效。方法 将符合纳入标准的60例患者随机分为两组,各30例。对照组采用手法淋巴引流联合地奥司明片治疗,观察组在对照组的基础上加用中药益气活血消肿汤治疗,两组均持续治疗1个月。观察两组患者的疗效,评估患侧上肢周径、疼痛、肩关节活动度、中医临床症状改善情况、生活质量和安全性。结果 患侧上肢周径变化方面,观察组明显优于对照组(P<0.05);疼痛缓解方面,两组患者VAS评分均较治疗前降低,且观察组改善更明显(P<0.05);肩关节活动度方面,两组患者均较治疗前有所改善,且观察组在前屈方面的改善效果明显优于对照组(P<0.05),而在后伸、内收、外展方面,两组无明显差异(P>0.05);中医临床症状改善方面,观察组总有效率(86.67%)显著高于对照组(50.00%)(P<0.05);生活质量方面,两组患者五项功能评分均校治疗前明显升高,且观察组生理状况改善程度显著优于对照组(P<0.05),其余功能两组无明显差异(P>0.05);安全性方面,两组患者治疗前后均未出现与治疗相关的不良反应,血常规、大小便常规、肝肾功能及心电图均未见异常,且无明显毒副作用。结论 益气活血消肿汤可有效减轻BCRL患者的患侧上肢水肿,缓解疼痛,改善肩关节活动度及临床症状,提高生活质量,且安全性较高。 相似文献
106.
107.
目的研究气囊上滞留物间歇吸引降低机械通气患者早期呼吸机相关肺炎(ventilator-associated pneumonia,VAP)的作用。方法选择机械通气超过48h的患者58例,随机分为气囊上滞留物间歇吸引组(观察组,n=28)和普通人工气道护理组(对照组,n=30)。比较两组患者VAP的发生率和气囊上滞留物的含菌量。结果观察组气囊上滞留物含菌量显著低于对照组(P〈0.05);观察组1周内VAP发生率(7.1%)低于对照组(33.3%),差异有统计学意义(P〈0.05)。结论气囊上滞留物间歇吸引可降低声门下气囊上区含菌量,降低早期VAP的发生率。 相似文献
108.
Qiang Pu Jian Zhou Quan Zheng Jianqi Hao Dongsheng Wu Ruoxi Zhang Hang Wang Tengyong Wang Lunxu Liu 《Interactive Cardiovascular and Thoracic Surgery》2022,35(1)
Open in a separate window OBJECTIVESThe optimal location to insert a chest tube for postoperative drainage has not been identified. We performed a retrospective equivalence study to identify whether the efficiency is similar regarding anterior or posterior position of chest tube in thoracic cavity after video-assisted thoracoscopic surgery for non-small-cell lung cancer.METHODSA retrospective review of 4263 patients undergoing non-small-cell lung cancer resection from October 2009 to August 2019 in the Western China Lung Cancer Database was conducted. Propensity score matching was performed to balance baseline characteristics between anterior and posterior groups. Chest tube duration, drainage volume, postoperative complications and hospitalization cost were compared. Equivalence margin was defined as (−1, 1) in 95% confidence interval of the mean difference of chest tube duration.RESULTSAfter propensity score matching, we investigated 2912 patients with anterior or posterior (1456 vs 1456) chest tube location following lung cancer resection. The mean time to chest tube removal was 3.39 days in the anterior group and 3.38 days in the posterior group (P = 0.52), while the mean difference and 95% confidence interval were 0.02 (-0.17, 0.20). The mean postoperative hospital stays in 2 groups were 5.47 vs 5.24 days (anterior vs posterior, P = 0.02). No significant differences were identified regarding the drainage volume during the first 3 postoperative days, postoperative complications and hospitalization cost.CONCLUSIONSThe comparison of clinical outcomes between anterior and posterior location of chest tube met the criteria for equivalence. For lung cancer patients undergoing video-assisted thoracoscopic surgery resection, it was free choice on anterior or posterior single-tube insertion. 相似文献
109.
P Jayasri Subashini Kaliaperumal Geeta Behera Mary Stephen 《Indian journal of ophthalmology》2022,70(12):4212
Purpose:This study was conducted to assess the intraocular pressure (IOP) control and postoperative complications following a non-valved glaucoma drainage device (GDD) surgery in refractory glaucoma.Methods:This was a prospective interventional study conducted on patients with glaucoma refractory to maximal medications or failed surgical treatment who underwent Aurolab aqueous drainage implant (AADI; Aurolabs, India) surgery. Primary outcome measures were IOP control, postoperative complications, and reduction in the number of antiglaucoma medications (AGM).Results:Thirty-four eyes were analyzed and the mean follow-up was 16.06 ± 5.63 months. The preoperative median (Q1, Q3) IOP was 31 mmHg (28, 36.5) which decreased to 12 mmHg (12, 14) at 6 months postoperatively. The median (Q1, Q3) number of AGMs decreased from 3 (3, 4) to 0 (0, 1). Significant complications like implant extrusion and tube exposure were noted in two eyes. The total success and failure rates at 6 months were 91.1% and 8.8%, respectively.Conclusion:AADI is effective in achieving target IOP and significantly reduces the use of AGMs with good safety in the short term. Long-term follow-up studies are needed to assess long-term IOP control and cost-effectiveness. 相似文献
110.
Arjun Desai Deepika C Parameswarappa Sirisha Senthil Sushma Jayanna Rajeev Reddy Pappuru Subhadra Jalali Padmaja Kumari Rani 《Indian journal of ophthalmology》2022,70(12):4349
Purpose:To describe the clinical features and treatment outcomes in spontaneous uveal effusion syndrome (UES).Methods:A 10-year retrospective chart review of UES patients from a tertiary eye center was carried out. Optical coherence tomography (OCT), fundus fluorescein angiography, and ultrasound biomicroscopy (UBM) scans were performed. UES was managed based on presenting best-corrected visual acuity (BCVA), symptoms, and fundus findings. Patients with secondary causes of uveal effusion were excluded.Results:Twenty-five eyes of 16 patients were included. Of the 16 patients, 14 (88%) were male and 9 (56%) had bilateral disease. Fifteen of 25 affected eyes had nanophthalmos (axial length (AL) <20.5 mm) and 6 had hyperopia with AL >20.5 mm. The presenting mean distance BCVA was 0.74 ± 0.64 logMAR (mean Snellen: 20/100). Eleven eyes had exudative retinal detachment, and 4 also had exudative choroidal detachment (CD). Choroidal thickness (CT) was increased in 11 eyes on B-scan ultrasonography, and the mean CT was 1.74 ± 0.38 mm. Sub-retinal fluid (SRF) and retinal folds were the most common OCT findings. UBM findings included shallow angles, peripheral CD, and supra-ciliary effusion. A combination of local and systemic corticosteroids was used to successfully treat 12 eyes, 6 needed surgery, and 7 were observed. Partial sclerectomy with anterior chamber maintainer-assisted SRF drainage was the favored surgery. The median period of follow-up was 6.5 months (0.1–76 months), and the mean distance BCVA at the last follow-up was 0.58 ± 0.42 logMAR (mean Snellen: 20/80).Conclusion:UES can be suitably managed both medically and surgically based on clinical presentation. 相似文献