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妊娠高血压综合征剖宫产后双眼视网膜中央动脉阻塞

新生血管性青光眼睫状体冷凝后交感性眼炎一例

肛瘘手术前后的护理体会

目的　探讨肛瘘患者手术前后护理的重要性。 方法　将2012年3月－6月行肛瘘手术的140例患者随机分为观察组及对照组：对照组行常规护理措施，观察组采取整体护理措施（包括术前准备，术后创口疼痛、出血、尿潴留、晕厥与呕吐、饮食与排便、坐浴与换药的护理，出院指导），并对两组患者健康教育内容评分、护理满意度及自我护理能力评分进行分析比较。 结果　观察组在健康教育内容评分、护理满意度及自我护理能力评分方面优于对照组。 结论　对肛瘘手术患者采用整体护理措施，提高了手术前后健康教育质量及患者自我护理能力，值得临床运用。

The clinical analysis of intraocular pressure elevation after pars plana vitrectomy

Objective To investigate the risk factors of the intraocular pressure (IOP) elevation after pars plana vitrectomy (PPV). Methods Eighty-eight patients (88 eyes) of postoperative ocular hypertension in a series of 339 patients who had undergone PPV with normal ocular pressure before operation were retrospectively studied. The ocular pressures in both preoperative and postoperative periods were detected by NCT examination, and the ocular hypertension was decided on the level of ≥25 mm Hg. The relationships of occurence of the time of onset and duration of persistence of postoperative ocular hypertension with the different kinds of primary diseases, the techniques of operation, and the condition whether or not the affected eyes had formerly accepted surgical intervention, were analyzed. Results The IOP elevation occures mostly within 1 to 2 weeks postoperatively (77 eyes, 87.5%). In 65 cases (65 eyes) IOP returned to normal in 1 week, and in another 14 cases (14 eyes) in 1 month after treatments. Six patients’ (6 eyes ) IOP was under 25 to 30 mm Hg with the medicine. With sustained elevation of IOP over 4 to 6 months, 3 cases (3 eyes ) lost or almost lost their vision finally. The probability of postoperative IOP elevation in the patients suffered from the retinal detachment with proliferative vitreoretinopathy (PVR) ≥grade C-2 was the highest in all the patients in our study (38.2%, P＜0.05). The patients who had intraocular surgery before were more likely to have IOP elevation than the ones without intraocular surgery (P＜0.05). Placement of a scleral buckle, use of expansile gases or silicone oil injection and scatter endophotocoagulation intraoperatively were related to the postvitrectomy IOP elevation (γ=0.829, P＜0.001). Conclusions The previous intraocular surgeries, certain primary eye diseases and combined ocular procedures are the risk factors of IOP elevation after PPV. (Chin J Ocul Fundus Dis, 2002, 18: 106-108)

胰十二指肠切除术后出血的病因及处理(附42例分析)

目的总结胰十二指肠切除术(pancreaticoduodenectomy，PD)后出血的原因和防治措施。 方法回顾性分析2008年1月至2014年1月期间哈尔滨医科大学附属第二医院行PD治疗的423例患者的临床资料。 结果PD术后发生出血42例(9.9%)，其中死亡9例(21.4%)。42例中早期出血23例，死亡2例，死亡率为8.7%；晚期出血19例，死亡7例，死亡率为36.8%；早期出血的死亡率低于晚期出血(P=0.014)。腹腔出血28例，死亡7例，死亡率为25.0%；消化道出血14例，死亡2例，死亡率为14.3%，腹腔出血的死亡率高于消化道出血(P=0.028)。轻度出血15例，死亡2例，死亡率为13.3%；重度出血27例，死亡7例，死亡率为25.9%，轻度出血死亡率低于重度出血病死率(P=0.037)。胰管空肠黏膜对黏膜吻合术后发生出血11例，出血率为10.6%，非黏膜对黏膜吻合术后发生出血31例，出血率为9.7%；2组比较，差异无统计学意义(P＞0.05)。手术治疗24例中死亡3例(12.5%)。 结论轻度腹腔出血和消化道出血经非手术治疗多可治愈；晚期腹腔出血手术难度大，可尝试介入治疗；术中精细操作、选择熟练吻合方式，预防胰瘘、胆瘘及腹腔脓肿可减少术后出血的发生。

半导体激光光凝致睫状神经损伤二例

Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens

Objective To approach the clinical characters and therapeutic methods of retinal detachment(RD) after extracapsular catarat extraction(ECCE)with posterior chamber intraocular lens(PCIOL). Methods Sixty eight cases(68 eyes) of RD after ECCE with PCIOL were treated with sclerel buckling,microvitreo retinal surgery and intraocular gas,silicone oil injection and were reviewed. Results The retinas were totally reattached in 65 eyes(95.59%) which dropped to 94.12% in 6-60 months postoperatively.The resultant rate of visual acuity of the eyes with 0.1 or better was 79.41%,with 0.3 or better was 26.47%. Conclusion The main causes of RD after ECCE with PCIOL are similar to those of general RD,and most cases of RD after ECCE with PCIOL can be cured by surgical treatment. (Chin J Ocul Fundus Dis,1998,14:167-169)

视网膜脱离术后前部炎症性坏死型巩膜炎二例

The Effect of Hypoxic Preconditioning on Old Rat Model of Postoperative Fatigue Syndrome Caused by Excision of Bilateral Accessory and Hysterectomy

目的:研究缺氧预处理对老年大鼠子宫及双附件切除术后疲劳是否有改善作用,并通过对比观察超氧化物歧化酶及丙二醛水平的变化,初步探讨缺氧预处理的作用机制。方法:将老年大鼠分为空白对照组、对照组、缺氧预处理三组。空白对照组为假手术组,对照组为子宫及双附件切除术组, 缺氧预处理组为缺氧预处理加子宫及双附件切除术组。对比观察缺氧预处理对大鼠体力活动及血清超氧化物歧化酶和丙二醛水平的影响。结果:空白对照组、对照组、缺氧预处理三组大鼠悬尾不动时间分别为:(21±3)s,(83±10)s,(44±5)s,各组间比较Plt;0.05。三组SOD活性分别为:(131.23±5.31)U/L,(36.12±9.68)U/L,(73.01±9.82)U/L,各组间比较Plt;0.05。三组MDA水平分别为:(9.78±1.26)μmol/L,(29.87±3.13)μmol/L,(15.98±2.21)μmol/L,各组间比较Plt;0.05。结论:缺氧预处理可提高老年大鼠的抗氧化能力,对老年大鼠子宫及双附件切除术后疲劳综合征有明显的改善作用。

Experimental research of intraocular retention of domestic perfluorocarbon liquid

Objective To investigate the effect of long-term intraocular retention of domestic perfluorocarbon liquid (PFCL) on morphology and histology of ocular tissues. Methods A total of 18 New-Zealand rabbits were randomly divided into 3 experimental groups, whose left eyes underwent intraocular injection with 0.3, 0.6, and 1.0 ml PFCL, respectively. All of the right eyes of the rabbits were in the control group. The morphological, electrophysiological and histological changes of the ocular tissue were observed 4, 8, and 12 weeks after the injection. Results No clinically significant retinopathy but only mild morphological changes were found in group 1 and 2, while obvious morphological and histological changes were found in group 3. Mild morphological and histological changes were found in all of the rabbits 4-8 weeks after the injection while significant ones were found 8-12 weeks after the injection. The results of electroretinography indicated a statistically significant decline of amplitude of b wave in group 3. Conclusions Long-term intraocular retention of few PFCL may cause mild histological changes but not affect the clinical function. Plentiful PFCL remains in eyes may lead to toxic reaction to the ocular tissue. (Chin J Ocul Fundus Dis, 2006, 22: 128-130)