Comparison of efficacy of two different silicone hydrogel bandage contact lenses after T-PRK

AIM:To compare the efficacy between two different silicone hydrogel bandage contact lenses after transepithelial photorefractive keratectomy(T-PRK).METHODS:In this randomized controlled trial,a total of 89 patients(178 eyes) who underwent T-PRK at the Qingdao Eye Hospital from October to December 2019 were selected.One random eye wore a Senofilcon A bandage contact lens after surgery,and the other eye a Balafilcon A bandage contact lens.Pain scores,uncorrected visual acuity(UCVA),spherical equivalent(SE),corneal epithelial healing status,epithelial thickness,bandage lenses deposits,lenses movement,and ocular surface conditions were measured and compared.RESULTS:There were no differences between the two groups in UCVA,SE,corneal epithelial healing status,corneal epithelial thickness,tear river heights and tear film rupture time at each follow-up visit.However,postoperative pain scores in the Senofilcon A group were significantly lower than those of the Balafilcon A group(F_intergroups=67.833,P<0.001;F_time=383.773,P<0.001;F_interaction=57.344,P<0.001).The duration of pain in eyes in the Senofilcon A group was shorter than that of the Balafilcon A group(t=-3.326,P=0.001).The surface deposition scores and movement scores of Senofilcon A bandage lenses on the first and fourth days after surgery were lower than those of Balafilcon A bandage lenses(Z=-5.385,-6.782,P<0.001;Z=-8.336,-8.906,P<0.001).CONCLUSION:Both Senofilcon A and Balafilcon A bandage lenses have good efficacy after T-PRK.Senofilcon A lenses are associated with less pain and more comfort compared to Balafilcon A.     

桡动脉穿刺术后不同止血方法随机对照试验的Meta分析

目的：评价桡动脉穿刺术后两种不同压迫止血方法的效果。方法收集国内多个数据库符合入选标准的6篇临床对照研究文献,采用固定效应模型和随机效应模型对1017例患者分别采用动脉压迫器与弹力止血绷带的术后效果进行Meta分析。结果6篇临床对照研究中,桡动脉压迫器降低皮下渗血与血肿率的效果明显（OR＝0．30,95％CI 0．08～0．43,P＜0．05）;桡动脉压迫器降低术后肢体肿胀率的效果明显（OR＝0．14,95％CI 0．10～0．19,P＜0．05）。结论桡动脉压迫器相对于传统的弹力绷带在降低术后并发症,尤其是降低皮下渗血与血肿以及预防术后肢体肿胀方面效果明显。     

飞秒激光制瓣的LASIK术后早期配戴绷带型角膜接触镜的临床观察

目的 观察绷带型角膜接触镜对飞秒激光制瓣的LASIK(femtosecond-LASIK,FS-LASIK)的影响.方法 选取45例(90眼)近视患者于我院屈光中心行双眼FS-LASIK术,术毕时随机选一眼给予Pure Vision软性绷带型角膜接触镜(戴镜组),并于术后第3天复诊时取出,另一眼作为非戴镜组,不戴角膜接触镜.对比戴镜组与非戴镜组术后1d、3d、1周、1个月、3个月的角膜瓣对合情况、主观症状评分.观察戴镜组与非戴镜组术前、术后1周、1个月、3个月的角膜荧光素染色、泪膜破裂时间、基础泪液分泌量、下泪河面积、裂隙灯检查以及术后角膜瓣并发症情况.术前及术后各个时间点角膜荧光素染色评分、泪膜破裂时间、基础泪液分泌量、下泪河面积比较采用重复测量设计的方差分析.结果 角膜瓣对合情况:术后1d时戴镜组优于非戴镜组的比例占总数的66.7％(30例);术后3d时,戴镜组较好的比例略微下降为64.5％(29例);术后1周后,戴镜组与非戴镜组角膜瓣与基质床交界面差异不明显.术后1周、1个月、3个月时,戴镜组与非戴镜组的泪膜破裂时间、角膜荧光素染色评分、基础泪液分泌量、下泪河面积比较,差异均无统计学意义(均为P＞0.05).术后1 d 18.6％的患者表示配戴绷带镜较为舒适,32.6％认为并不舒适,而48.8％患者未感到明显差异;术后第3天上述主观症状的比例分别为:16.3％、51.2％及32.5％.结论 FS-LASIK术后早期常规配戴绷带型角膜接触镜有助于角膜瓣的贴附,使对合面更加平整和均匀,但在泪膜稳定性方面并没有明显作用.大部分患者并未因配戴绷带镜而有效缓解了主观不适的症状.     

新型三角巾--抗感染纳米银敷料三角巾的研制及应用前景研究

目的探讨实用新型专利纳米银三角巾作为灾害救援现场应用的便捷性、抗感染性、有效性。进一步讨论其作为紧急包扎治疗的作用效果。方法研制出纳米银敷料三角巾,寻找以往紧急救援中快速包扎消毒的方式方法以及作用效果,作为纳米银三角巾应用前景的对照组进行分析。以及NOS纳米银敷料做微生物抗菌实验的效果分析。结果实验结果明显,NOS纳米银对金黄色葡萄群菌和绿脓杆菌有显著的抑制作用,在实际运用中也能起到很好的抑菌防感染作用。而且三角巾群众认可度高,实际运用潜力大。结论与以往快速包扎消毒治疗的对比中可看出,纳米银三角巾的优势明显且突出,不仅能实施快速加压、止血、抗感染、降低伤残率。若在救援现场便捷使用,可减少医务人员每日对伤员换药的工作量。本品研制方法科学合理,并获得实用新型发明专利。能满足现场灾害医疗救援模式的需求。     

护理干预在青少年鼻内镜手术后复查换药中的应用体会

目的：分析护理干预在青少年鼻内镜手术后复查换药中的应用效果。方法：选取50例鼻内镜手术后复查换药青少年患者,随机分为干预组和常规组各25例,分别给予护理干预及常规护理,分析护理效果。结果：干预组护理满意度及用药依从性均高于对照组,疼痛指数少于对照组（P〈0.05）。结论：青少年鼻内镜手术后复查换药中采用护理干预,可明显减轻患者换药时的痛苦,提高患者的依从性,应用效果显著。     

乳腺癌术后双管引流加弹性包扎246例疗效观察

目的评价乳腺癌术后两部位双管引流加弹性包扎对降低术后皮下积液、皮瓣坏死的效果。方法将1998～2007年在我院行标准根治术或改良根治术的246例乳腺癌患者随机分成两组,对照组126例采用传统的腋下单管引流和普通绷带加压包扎,观察组120例采用腋下、胸骨旁双管引流及弹性绷带加压包扎。结果对照组中有25例（19.8%））发生皮下积液,13例（10.3%）发生皮瓣坏死;观察组中8例（6.7%）发生皮下积液,6例（5.0%）发生皮瓣坏死。两组比较差异有统计学意义。结论乳腺癌术后采用腋下、胸骨旁双管引流及弹性绷带加压包扎能降低术后并发症的发生率。     

Psoriasis improvement after gastric bandage in a patient partial responder to infliximab

Patients overweight or obese have more severe psoriasis than normal weight patients. Sometimes the excessive weight is related to a lack of efficacy of systemic treatment. We report a case of a psoriatic patient that experienced a dramatic improvement of psoriasis after weight loss surgery by gastric bandage. The great weight loss was accompanied by an effectiveness gain of response to infliximab. The mechanism responsible for this association is not certain, but it is probably multifactorial, involving genetic, environmental and immune‐mediated factors. It has been suggested that adipose tissue can dramatically alter the volume of drug distribution and limit drug efficacy. Moreover, a reduction of weight could favour the response to therapy and remission of the disease, inducing an improvement in patient's quality of life. Gastric bandage has a scarce rate of complications, a fast recovery and scarce life‐threatening complications. It should be considered in obese patient that not shown effectiveness to therapy.     

弹力绷带在皮损部位静脉留置针固定中的应用

临床工作中经常遇到重度水肿、皮肤病、烧伤等病人,由于皮肤的表层破损或皮肤的全层已经破坏,无法用输液敷贴将静脉留置针固定稳妥,易使针管脱出,造成穿刺失败。我院2008年以来,采用弹力绷带固定皮损部位静脉留置针,现介绍如下。