霜样树枝状视网膜血管炎是一种少见的急性视网膜血管炎,多发生于健康青少年,病因不明,可能与病毒感染有关,糖皮质激素治疗有效,预后良好;也可继发于感染性疾病和全身疾病,预后较差。该文回顾了一例继发于异基因造血干细胞移植后的霜样树枝状视网膜血管炎,治疗后病情缓解,预后良好。
Frosted branch angiitis (FBA) is a rare acute retinal vasculitis which often occurs in healthy adolescents. The etiology of FBA is unknown, but its occurrence may be related to viral infection, glucocorticoid therapy is effective and has a good prognosis. FBA may also be secondary to infectious and systemic diseaseswith poor prognosis. In this paper, we reviewed a case of FBA secondary to allogeneic hematopoietic stem cell transplantation, which was relieved after treatment and had a good prognosis.
目的:探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法:采用便利抽样法抽取行角膜移植日间手术的173例患者,采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果:角膜移植日间术后患者延续护理需求得分为88.13±15.55,其中,对疾病相关知识的需求得分最高,为4.39±0.66,对心理护理的需求得分最低,为2.72±1.18;在延续护理实施方式方面,74.6%患者倾向于电话随访,只有5.8%倾向于上门服务;在影响因素方面,婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论:角膜移植日间术后患者的延续护理需求较高,应根据患者延续护理需求及影响因素进行个性化指导,以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
真菌性角膜炎是我国导致角膜盲的重要原因之一。由于部分患者在感染早期缺乏合理治疗,导致病情迁延难治,最终行角膜移植是主要的治疗手段。然而真菌感染十分顽固,术后仍有一定概率复发。因此,了解真菌性角膜炎的最新研究进展以及不同类型抗真菌药物和角膜移植手术的优劣,根据适应证选择合理的治疗方案,才能最大程度控制感染,降低真菌复发率,挽救患者视力。与此同时,对角膜移植后真菌复发的相关文献进行研究,总结其复发规律、影响因素和临床特征以及治疗手段和预后。为制订合理的、符合国情的治疗策略提供参考依据。
Fungal keratitis is one of the important causes of corneal blindness in China. Due to the lack of reasonable treatment for some patients in the early stage of infection, the disease is protracted and refractory, and eventually, corneal transplantation is the main treatment. However, Fungal keratitis infection is very stubborn, and there is still a certain probability of recurrence after surgery. Therefore, understanding the latest research advances in fungal keratitis as well as the advantages and disadvantages of different types of antifungal drugs and corneal transplantation, and choosing a reasonable treatment plan according to the indications can maximize the control of the infection, reduce the recurrence rate of the fungus and save the vision of patients. In addition, the relevant literature on fungal recurrence after corneal transplantation was studied to summarize its recurrence pattern, influencing factors and clinical features, as well as treatment means and prognosis. The purpose of this study is to provide a reference basis for formulating a reasonable treatment strategy in line with China’s national conditions.
[摘 要] 目的:减轻行角膜移植术的患儿及家属的心理负担,提高患儿对手术的耐受性,减少术后并发症。方法:对45例将进行角膜移植的患儿进行围手术期护理。结果:所有患儿经过精心的治疗和护理后均恢复良好,视力均有提高。结论:术前做好充足的准备、术前心理护理,术后严密观察生命体征和眼部敷料的情况,做好相关的生活和饮食指导,遵医嘱及时有效用药,注意患儿异常的反应及眼部的情况,及时发现并处理并发症,给予细致的出院指导,有利于患儿早日康复。
Abstract Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. After operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery