角膜绷带镜对复发性翼状胬肉术后角膜上皮愈合和疼痛评分及角膜规则度的影响

目的：研究角膜绷带镜对复发性翼状胬肉患者术后角膜上皮愈合、疼痛程度评分和角膜表面规则度的影响。

方法：回顾性病例研究。将2015-09/2017-09就诊于湖州师范学院附属第一医院并行手术治疗的64例64眼复发性翼状胬肉患者,根据术后是否使用角膜绷带镜分组,A组34眼术后配戴1wk角膜绷带镜,B组30眼术后不使用角膜绷带镜。采用荧光素钠角膜染色法评价翼状胬肉患者术后1d和1wk时角膜上皮愈合程度; 通过视觉模拟评分法评估患者术后2h,1d,1wk时疼痛程度; 采用角膜地形图系统分析术前及术后1mo时角膜表面规则指数、角膜表面不对称指数和角膜散光情况。

结果：A组患者术后1d,1wk时角膜上皮愈合评分与B组相比,差异均有统计学意义(P<0.01)。A组患者术后各时间点的疼痛程度评分均明显低于B组,差异均有统计学意义(P<0.01)。A组患者术前角膜表面规则指数、角膜表面不对称指数及角膜散光与B组相比,差异无统计学意义(P>0.05),而术后1mo时角膜表面规则指数、角膜表面不对称指数及角膜散光与B组相比,差异均有统计学意义(P<0.01)。

结论：复发性翼状胬肉患者术后配戴角膜绷带镜,有助于角膜上皮愈合,减轻术后刺激症状,改善角膜表面规则度,降低术后角膜散光。     

翼状胬肉转位术联合羊膜移植加绷带型角膜接触镜治疗翼状胬肉

目的：探讨翼状胬肉转位术与羊膜移植加绷带型角膜接触镜治疗翼状胬肉的临床疗效。

方法：本研究纳入观察对象为2014-12/2016-12于我院治疗的翼状胬肉患者72例80眼,按照治疗方式不同分为两组,对照组35例39眼行翼状胬肉转位术联合羊膜移植治疗,观察组37例41眼在此基础上加用绷带型角膜接触镜治疗; 随访1a,观察术后视力变化,评价手术疗效,比较两组患者术后疗效、复发率以及角膜愈合天数,术前、术后1d,1、3、6、12mo采用非接触式眼压计检测眼压变化,记录术后并发症发生情况。

结果：观察组术后疗效Ⅰ级19眼、Ⅱ级11眼、Ⅲ级8眼、Ⅳ级3眼,对照组Ⅰ级16眼、Ⅱ级12眼、Ⅲ级8眼、Ⅳ级3眼,两组比较差异无统计学意义(P>0.05); 观察组视力提升20眼、无变化17眼、视力下降4眼,对照组视力提升16眼、无变化17眼、视力下降6眼,两组比较差异无统计学意义(P>0.05); 观察组角膜愈合时间为3.43±1.03d,对照组为5.13±1.16d,差异具有统计学意义(P<0.05); 两组患者术前和术后1d,1、3、6、12mo眼压比较差异无统计学意义(P>0.05); 术后对照组出现1眼角膜瘢痕,两组患者均未出现眼压升高、角膜散光等并发症。

结论：采用翼状胬肉转位术联合羊膜移植加绷带型角膜接触镜能显著提高角膜愈合时间,疗效确切,安全有效。     

Evaluation of the safety and efficacy of therapeutic bandage contact lenses on post-cataract surgery patients

AIM: To evaluate the safety of therapeutic bandage contact lens for post-cataract surgery patients and to illustrate its efficacy on post-operative comfort and tear-film stability. METHODS: A total of 40 participants were recruited and randomly divided into two groups. Group one was instructed to wear bandage contact lenses for a week and use antibiotic eye drops for a month since the first day after surgery. Group two received sub-conjunctival injection of tobramycin and was asked to wear eye pads on the first day after surgery and then were instructed to use antibiotic eye drops as the first group did. Ocular surface disease index (OSDI) questionnaire, slit-lamp microscope examination of tear break-up time (TBUT), corneal fluorescein score (CFS), tear meniscus height (TMH) together with anterior segment optical coherence tomography (AS-OCT) and corneal topography were evaluated preoperatively and postoperatively. RESULTS: The subjective feeling (P=0.004), TBUT (P<0.001) and TMH (P=0.02) post-surgery had improved in patients who used bandage contact lenses compared with those who did not at 1wk post-surgery. Until three month postoperatively, the comfort degree (P=0.004) and TMH (P=0.01) of group two were still worse than group one. Moreover, TBUT (P<0.001) and CFS (P=0.004) of the group with eye pads got worse than the results before, whereas the group with bandage contact lenses recovered to normal. None of these patients had infections or other complications. CONCLUSION: Wearing therapeutic bandage contact lens after cataract surgery, compared with traditional eye-pads, is a safe method to improve tear-film stability and reduce post-operative discomfort without hindering corneal incision recovery.     

双止血带负压法在腹泻合并重度脱水患儿输液中的应用

目的 探讨双止血带负压法建立有效静脉通道在腹泻合并重度脱水患儿输液中应用的临床价值.方法 将133例腹泻合并重度脱水患儿作为研究对象,随机分为观察组68例和对照组65例.观察组采用双止血带负压输液法进行静脉穿刺,而对照组采用传统输液法进行静脉穿刺,两组患儿均选择手背静脉作为穿刺部位,观察两组患儿静脉充盈程度.以第一次穿刺即可见回血为穿刺成功的观察指标,分别统计两组患儿静脉充盈度及穿刺成功的例数,并进行比较.结果 观察组静脉充盈表浅为38.24%,充盈明显和充盈饱满为61.76%,穿刺成功率为89.71%;而对照组静脉充盈表浅为66.15%,充盈明显和充盈饱满为33.85%,穿刺成功率为66.15%.两组比较,χ2值分别为10.38、10.81,均有非常显著性差异(P值均<0.01).结论 双止血带负压法可明显地提高腹泻合并重度脱水患儿静脉充盈程度及穿刺的成功率,为腹泻合并重度脱水患儿建立有效静脉通道开拓了一种新途径,对腹泻合并重度脱水患儿输液治疗,挽救患儿的生命具有非常重要的现实意义.     

乳腺癌根治术后创面不加压包扎对预防皮瓣坏死的影响

目的探讨乳腺癌术后皮瓣坏死的发生原因及预防措施。方法回顾性分析2006年1月～2010年12月郑州人民医院280例乳腺癌手术患者的临床资料,其中创面加压包扎140例,创面不加压包扎140例。结果乳腺癌根治术后创面加压包扎皮瓣坏死29例,发生率为20.71%,创面不加压包扎皮瓣坏死15例,发生率为10.71%。结论乳腺癌根治术后创面不加压包扎是预防皮瓣坏死的一种方法。     

普拉洛芬滴眼液联合角膜绷带镜治疗复发性角膜上皮糜烂

目的 研究普拉洛芬滴眼液联合角膜绷带镜治疗复发性角膜上皮糜烂的有效性.方法 选择63例(63眼)复发性角膜上皮糜烂患者,按治疗方法不同分为普拉洛芬组(32例32眼)及对照组(31例31眼).两组均配戴角膜绷带镜,并每2周更换一次,持续3个月.治疗时两组患眼均使用左氧氟沙星滴眼液和玻璃酸钠滴眼液滴眼,普拉洛芬组还加用普拉...     

The treatment of acute soft tissue trauma in Danish emergency rooms

Rest, ice, compression, elevation (RICE) is the most recommended treatment for acute traumatic soft tissue injuries. A questionnaire was given to all Danish emergency rooms ( n = 51) regarding their routines for acute treatment of ankle sprains and muscle contusions. Complete answers were received from 37 emergency rooms (73%), covering the treatment of 111 ankle sprains and 101 muscle contusions. Treatment with RICE was given in a minority of injuries, ice (21%), compression (32%) and elevation (58%) similarly between injury types. A complete RICE treatment was rarely applied (3%). Verbal information on RICE and rehabilitation was given in less than half of the cases. We conclude that the acute treatment of ankle sprains and muscle contusions in the Danish emergency rooms is not applied in accordance with consensus from international literature, and that the instruction in rehabilitation should be improved.     

弹力绷带加压包扎联合低分子肝素对全髋关节置换患者下肢深静脉血栓的影响

目的探讨弹力绷带下肢加压包扎联合低分子肝素(Low molecular weight heparin,LMWH)预防全髋关节置换(Total hip arthroplasty,THA)患者下肢深静脉血栓(Deep venous thrombosis,DVT)的临床效果。方法回归分析2014年1月~2015年10月初次行全髋关节置换病例120例,所有患者皆使用低分子肝素抗凝以预防血栓形成,根据术后下肢是否采用弹力绷带加压包扎分为观察组和对照组。记录并观察术前血小板(Platelet,PLT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、凝血酶原时间(Prothrombin time,PT)、甘油三酯(Triglyceride,TG)、纤维蛋白原(Fibrinogen,FIB)、总胆固醇(Cholesterol,CHOL)、手术时间及术后引流量;采用彩色多普勒检查评估深静脉血栓形成情况。结果两组患者基线特征一致,具有可比性。术前两组PLT、APTT、PT、TG、FIB、CHOL及手术时间比较,差异无显著性意义(0.05)。观察组术后引流量高于对照组,但两组比较,差异无显著性意义(0.05)。术后深静脉血栓形成观察组少于对照组,但两组经卡方检验,差异无显著性意义(0.05)。结论弹力绷带下肢加压包扎联合低分子肝素预防THA术后深静脉血栓形成与单独使用低分子肝素比较无明显统计学差异,其是否能够明显减少DVT数量尚需扩大样本量进行深入研究。