泪器病专栏

泪道支架材料的研究进展

Research progress on lacrimal duct stent materials

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泪道阻塞是临床常见的眼科疾病,主要表现为溢泪、反复感染等症状,严重影响患者的生活质量。传统治疗方法主要采用硅胶或金属支架置入术,这些材料虽然能够暂时维持泪道通畅,但由于其不可降解性、容易移位、易形成生物膜导致感染等固有缺陷,往往需要二次手术取出,给患者带来额外的痛苦和经济负担。随着材料科学和生物医学工程的发展,新型支架材料的研发为解决这些问题提供了新的思路。文章聚焦新型材料如可降解材料、3D打印个性化支架、复合材料及表面改性技术等,这些材料可通过材料降解、精准适配或多功能整合提升临床疗效,但在降解速率调控、3D打印精度及成本方面仍面临诸多挑战。此外,这些新技术的长期安全性和有效性还需要更多临床数据的支持,在未来仍需不断探索,开发更精准的降解速率调控方法,优化3D打印流程以提高精度,降低材料制备的成本,探索更高效的复合材料制备技术。同时,要加强基础研究,推动更多创新技术在临床的应用,开发出更安全、更有效的新型泪道支架材料,为泪道阻塞患者提供更优质的治疗方案,推动泪道疾病治疗向精准微创化方向发展。
Lacrimal duct obstruction is a common clinical ophthalmic condition characterized by symptoms such as epiphora and recurrent infections, significantly impairing patients' quality of life. Traditional treatments primarily involve the implantation of silicone or metal stents. While these materials can temporarily maintain lacrimal duct patency, their inherent drawbacks—such as non-degradability, susceptibility to displacement, and tendency to form biofilms leading to infections—often necessitate secondary surgeries for removal, imposing additional physical and financial burdens on patients.Advances in materials science and biomedical engineering have introduced novel stent materials as potential solutions to these challenges. This article focuses on emerging materials such as biodegradable polymers, 3D-printed personalized stents, composite materials, and surface modification technologies. These innovations can enhance clinical outcomes through material degradation, precise customization, or multifunctional integration. However, challenges remain in regulating degradation rates, improving 3D printing precision, and reducing costs.Furthermore, the longterm safety and efficacy of these technologies require more clinical data for validation. Future research should explore more precise degradation rate control methods, optimize 3D printing processes to enhance accuracy, lower material production costs, and develop more efficient composite material fabrication techniques. Concurrently, strengthening fundamental research and promoting the clinical application of innovative technologies will be crucial to developing safer and more effective lacrimal duct stent materials. Such advancements will provide superior treatment options for patients with lacrimal duct obstruction and drive the field toward minimally invasive and precision medicine approaches.
经验交流

05-6 眼科住院医师规范化培训中人文素养培育的实践与探索【注意题名需要进一步确认】

Practice and exploration of cultivating humanistic qualities in standardized training of ophthalmology residents

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在眼科住院医师规范化培训中,医学人文素质的培养对医患沟通能力与职业素养的塑造具有重要价值。医学人文不仅关乎医生的执业能力,更直接影响医疗服务的质量与患者满意度。文章分析了当前眼科住培医师人文素养教育现状及其重要性。在此基础上,提出了培养住培医师的人文素质的方法和途径:1)通过入培前的人文素养专题培训,强化住培医师的医患沟通意识,使其在进入临床实践前就树立正确的人文理念;2)借助医院服务中心的实践活动,让住培医师亲身参与患者服务,从而培养他们的同理心,更好地理解患者的需求与感受;3)开展医学人文读书活动,引导住培医师阅读经典人文著作,深化他们的人文情怀,提升职业素养;4)组织科室人文析议会,针对临床实践中常见的伦理困境进行研讨,帮助住培医师学会在复杂情境中做出合理决策;5)实施思政与医学人文融合的实践,拓展住培医师的人文视野,使其在专业技能提升的同时,不忘人文初心。该文旨在为眼科住培医师的人文素质培养提供理论支持和实践指导。通过这些方法的实施,期望培养出更多具备高人文素养的眼科医疗专业人才。
Strengthening medical humanities education is of vital significance in the standardized training of ophthalmology residents, as it contributes to enhancing their doctor-patient communication skills and professional ethics. This paper examines the current situation and significance of humanities education for ophthalmology residents. On this basis, the paper suggests five concrete methods and approaches for fostering residents' humanistic qualities, such as: (1) strengthening doctor-patient communication awareness through pre-training humanities courses to establish a proper humanistic mindset before clinical practice; (2) developing empathy by participating in hospital service center activities through hands-on patient service experiences; (3) deepening humanistic sentiment and enhancing professional ethics through medical humanities reading activities featuring classical works; (4) discussing clinical ethical dilemmas via departmental humanities analysis meetings to help residents develop decision-making skills in complex scenarios; (5) expanding humanistic horizons through the integration of ideological and political education with medical humanities practice, ensuring professional skill development aligns with humanistic principles. This paper aims to offer theoretical support and practical guidance for the humanities education of ophthalmology residents, with the objective of cultivating more ophthalmology professionals with both clinical excellence and high humanistic caliber.
论著

05-7 基于我院小儿眼科常见病种分析儿童眼科药物临床试验现状

Analysis of the current situation of clinical trials of ophthalmic drugs in children based on the common diseases of pediatric ophthalmology in hospital

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目的:结合院小儿眼科常见病种调研国内儿童眼用制剂药物临床试验开展现状,为儿童眼用制剂药物临床试验的发展提供参考。方法:基于国家药物临床试验登记与信息公示平台和医院信息系统结合郑州市第二人民医院儿童眼科病种,分析儿童眼科药物临床试验开展情况。 结果:院门诊就诊患者以屈光不正最多(占68.49% ),其次是结膜炎(占11.25%,再次是斜视(占8.60%)。平台共检索到相关临床试验165项,儿专用药物临床试验25项,其中延缓青少年近视方面试验24个,小儿结膜炎试验1个,其他病种药物临床试验检测结果为0;药物临床试验中以I期和期临床试验为主;延缓青少年近视方面试验已完成试验8项,其他都在进行中。结论:儿童眼科疾病的药物治疗尚有巨大的临床需求未满足,直接关系到了儿童健康权益保障与生命安全维护。当前国内儿童眼用制剂研发呈现企业参与度低、创新动力不足的现状,其核心制约因素在于项目少、难度大、涉及更多的伦理问题。建议通过政产学研协同创新,系统性推进儿童眼用制剂的研发进展,切实解决我国儿童眼病治疗用药难的问题,为儿童视觉健康提供有力保障。

ObjectiveCombined with the common diseases of pediatric ophthalmology in our hospital, the current situation of clinical trials of ophthalmic preparations for children in China was investigated to provide reference for the development of clinical trials of ophthalmic preparations for children in China. MethodsBased on the national drug clinical trial registration and information publicity platform and hospital information system, combined with the pediatric ophthalmic diseases in our hospital, the development of pediatric ophthalmic drug clinical trials was analyzed. ResultsAmong the outpatients in our hospital, ametropia was the most common ( 68.49 % ), followed by conjunctivitis ( 11.25 % ) and strabismus ( 8.60 % ). A total of 165 clinical trials and 25 clinical trials of pediatric drugs were retrieved from the platform, including 24 trials on delaying juvenile myopia, 1 trial on pediatric conjunctivitis, and 0 clinical trial on other diseases. Drug clinical trials were mainly phase I and phase III clinical trials. Eight trials have been completed to delay juvenile myopia, and others are in progress. ConclusionsThere is still a huge clinical demand for the drug treatment of children 's eye diseases, which is directly related to the protection of children 's health rights and life safety. At present, the research and development of children 's ophthalmic preparations in China presents the current situation of low enterprise participation and insufficient innovation motivation. The core constraints are fewer projects, greater difficulty, and more ethical issues. It is suggested to systematically promote the research and development of ophthalmic preparations for children through the collaborative innovation of government, industry, university and research, so as to effectively solve the problem of difficult medication for children 's eye diseases in China and provide a strong guarantee for children 's visual health.

论著

05-8 天津市某眼科专科医院急诊病例疾病谱分析

Epidemiological analysis of emergency ophthalmic cases in a specialist hospital in Tianjin

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目的:分析天津市某眼科医院急诊病例疾病谱,为规范疾病诊断流程、合理分配急诊医疗资源提供循证依据。方法回顾性分析20191~202312月在天津市某眼科医院急诊科就诊患者的临床资料,包括一般人口学资料、就诊时间、季节分布及初步诊断等结果共纳入26 077例眼科急诊患者,男女比例为1.12∶1,年龄为(36.82±15.44)岁,就诊年龄大多分布在<14岁(26.74%)及31~40岁(21.03%);日就诊时间分布中:10:00~12:0011.06%)、14:00~16:0010.41%)及20:00~22:0010.43%)就诊人数较多,05:00~07:004.83%)就诊人数较少;4月就诊人数最少(3.87%),8月就诊人数最多(11.61%),夏季就诊人数(31.74%)显著多于其他3个季节;眼科急诊患者最常见的10种初步诊断中结膜炎占比最多(39.58%),其次为干眼症(14.32%);与2019年相比,2020年和2021年眼科急诊患者前10种初步诊断显著下降(均P<0.001202095%CI-0.98~-0.68202195%CI-0.54~-0.11);与春季相比,其他季节眼科急诊患者前10种初步诊断显著下降(P<0.001,夏季95%CI-0.32~-0.08、秋季95%CI-0.39~-0.14、冬季95%CI-0.54~-0.30)。其中在结膜炎病例中,与春、夏季相比,冬季结膜炎病例分布呈显著下降趋势(P<0.00195%CI分别为-0.08~-0.03]、为-0.08~-0.04);眼科急诊患者前10种初步诊断性别分布具有统计学意义(P0.001);与14岁以下年龄段相比,其他年龄眼科急诊患者前10种初步诊断均呈下降趋势,(P<0.00114~2095%CI-0.88~-0.4321~3095%CI-1.01~-0.6531~4095%CI-1.10~-0.8241~5095%CI-0.97~-0.6651~6095%CI-1.71~-1.3861~7095%CI-1.45~-1.0871~8095%CI-1.36~-0.80>8095%CI-1.44,-0.22)。结论眼科急诊患者以儿童和中青年男性为主,14岁以下年龄段人群相比来说有较高风险;日就诊时间分布呈现出三个高峰一个低谷的显著特征,就诊高峰时段分别为10:00~12:0014:00~16:00以及20:00~22:00,就诊低谷出现在05:00~07:00期间;眼科急诊中最常见的诊断主要是那些通常被认为是非紧急的诊断,即结膜炎和干眼症;结膜炎的发病呈现明显的季节性特征,春、夏季为高发期;与2019年相比,2020年和2021年眼科急诊就诊总量显著减少,其中以结膜炎和干眼症的就诊量减少尤为明显,2022年有一定程度的恢复。

PurposeTo analyze the disease spectrum of emergency cases at an ophthalmology hospital in Tianjin, offering evidence-based support for standardizing diagnostic procedures and rationing emergency medical resources. Methods: Reviewed clinical data of patients at the hospital's emergency department from January 2019 to December 2023, covering demographics, visit timings, seasonal distribution, and preliminary diagnoses. Results: A total of 26,077 ophthalmology emergency patients were included, with a male-to-female ratio of 1.12:1 and an average age of 36.82±15.44 years. Most patients were aged <14 years (26.74%) and 31~40 years (21.03%). Daily visits peaked at 10:00~12:00 (11.06%), 14:00~16:00 (10.41%), and 20:00~22:00 (10.43%), and were lowest at 05:00~07:00 (4.83%). April had the fewest visits (3.87%), August the most (11.61%), and summer accounted for the highest quarterly proportion (31.74%). The top 10 preliminary diagnoses were led by conjunctivitis (39.58%) and xerophthalmia (14.32%). Compared to 2019, the top 10 preliminary diagnoses dropped significantly in 2020 and 2021 (both P<0.001), 2020 95%CI[-0.98~-0.68]2021 95%CI[-0.54~-0.11]. Similarly, these diagnoses were significantly lower in summer, autumn, and winter than in spring (all P<0.001), summer 95%CI[-0.32~-0.08]autumn 95%CI[-0.39~-0.14]winter 95%CI[-0.54~-0.30]. In conjunctivitis cases, winter incidence was significantly lower than in spring and summer (both P<0.001). Gender distribution in the top 10 diagnoses was statistically significant (P<0.001), 95%CI[-0.08~-0.03] and [-0.08~-0.04] . Compared to those aged <14, other age groups showed a downward trend in the top 10 preliminary diagnoses (all P<0.001), 14~20 95%CI[-0.88~-0.43]21~30 95%CI[-1.01~-0.65]31~40 95%CI[-1.10~-0.82]41~50 95%CI[-0.97~-0.66]51~60 95%CI[1.71~-1.38]61~70 95%CI[-1.45~-1.08]71~80 95%CI[-1.36~-0.80]>80 95%CI[-1.44,-0.22]Conclusions: Ophthalmology emergency patients are mainly children and middle-aged men, with those <14 years old at higher risk. Visit times follow a "three-peak-one-valley" pattern. Most diagnoses are non-urgent conditions like conjunctivitis and xerophthalmia. Conjunctivitis shows marked seasonality, peaking in spring and summer. Total ophthalmology emergency visits declined in 2020 and 2021 versus 2019, particularly for conjunctivitis and xerophthalmia, partially recovering in 2022.

论著

首诊眼科的 4 例 2 型神经纤维瘤病眼部病变特征

Characteristics of ocular alterations in four cases of neurofibromatosis Type 2 first diagnosed in ophthalmology

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目的:回顾2型神经纤维瘤病(neurofibromatosis type 2, NF2)患者的眼部表现,分析NF2眼部病变的临床和影像学特征,以助该病的早期诊断。方法:收集来自深圳市眼科医院的1例和来自中山眼科中心的3例NF2患者完整的临床资料并进行总结分析。结果:这4例患者均因眼部异常首诊于眼科且符合曼彻斯特诊断标准。4例患者中,3例为NF2早发型(<20岁),1例为晚发型(>20岁),男女比例1∶1。3例患者因视力下降、1例患者因复视首诊于眼科。3例行眼底光学相干断层成像(optical coherence tomography, OCT)检查显示,视网膜错构瘤2例,视网膜前膜2例,视盘隆起2例,视网膜神经纤维层和节细胞层变薄1例。其他表现包括麻痹性斜视2例,复视1例,白内障1例,球后段视神经增粗1例,眼眶肿瘤1例。结论:NF2的眼部表现多种多样,可出现在神经症状和听力损失之前。详细的眼科检查及影像学检查对年轻患者的早期诊断非常有价值,有助于选择更好的治疗计划。
Objective: Review the ocular manifestations of patients with neurofibromatosis type 2 (NF2), and analyze the clinical and imaging features of the ocular lesions in NF2, so as to facilitate the early diagnosis of this disease. Methods: The complete medical records of 1 case from Shenzhen Eye Hospital and 3 cases of NF2 from Zhongshan Ophthalmic Center were collected. Results: All four patients were first diagnosed in ophthalmology due to eye symptoms and met the Manchester diagnostic criteria. Of the four patients, three were NF2 early hairstyles (<20 years old), one was late hairstyle (>20 years old), and the male-to-female ratio was 1:1. Three patients were first diagnosed in the ophthalmology department due to decreased visual acuity, and one patient was first diagnosed due to diplopia. Optical coherence tomography (OCT) examinations were performed on three patients, which showed that there were two cases of retinal hamartoma, two cases of epiretinal membrane, two cases of optic disc elevation, and one case of thinning of the retinal nerve fiber layer and ganglion cell layer. Other manifestations included two cases of paralytic strabismus, one case of diplopia, one case of cataract, one case of thickening of the retrobulbar optic nerve, and one case of orbital tumor. Conclusions: The ocular manifestations of NF2 are diverse and can precede neurological symptoms and hearing loss. Detailed ophthalmic examinations and imaging studies are highly valuable for early diagnosis in young patients, aiding in the selection of a better treatment plan.
封面简介

内镜下泪囊鼻腔吻合联合人工泪管植入术治疗小泪囊型泪囊炎 的疗效分析

Efficacy of endoscopic dacryocystorhinostomy combined with bicanalicular silicone tube intubation for the management of chronic dacryocystitis with small lacrimal sac

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       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型,目前尚无针对小泪囊的确切定义,传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm),提出开放泪总管平面技术以扩大泪囊鼻腔吻合口,同时联合双管人工泪管植入术的En-DCR治疗方案,术后予以肾上腺皮质激素(激素)喷鼻剂辅助,显著提升手术疗效。
      研究纳入61例小泪囊型泪囊炎患者,术后9个月随访显示,解剖成功率达80. 33%(49/61),功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口;短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比,该方案突破小泪囊手术禁忌,为患者提供更优选择。
       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型,目前尚无针对小泪囊的确切定义,传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm),提出开放泪总管平面技术以扩大泪囊鼻腔吻合口,同时联合双管人工泪管植入术的En-DCR治疗方案,术后予以肾上腺皮质激素(激素)喷鼻剂辅助,显著提升手术疗效。
      研究纳入61例小泪囊型泪囊炎患者,术后9个月随访显示,解剖成功率达80. 33%(49/61),功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口;短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比,该方案突破小泪囊手术禁忌,为患者提供更优选择。
综述

双眼视与执行能力的交互关系:基于神经机制与临床影响的研究

The interactive relationship between binocular vision and executive ability: a study based on neural mechanisms and clinical impact

:355-362
 

双眼视,即双眼同时工作、协调和整合视觉信息的能力,能够产生单一、立体和深度感的视觉体验,近年来在认知心理学和神经科学研究中逐渐受到越来越多的重视,尤其是在探讨其与执行能力之间复杂关联的方面。执行能力作为一项至关重要的认知功能,涉及多个方面,包括注意力、工作记忆、决策和问题解决等,这些因素共同影响着个体在日常生活和工作中的表现和效率。当前的研究表明,双眼视不仅在视觉信息的处理上发挥着关键作用,还对个体的执行能力产生了显著的影响。双眼视异常群体(如斜视、弱视患者)在执行功能测试中普遍表现出反应抑制延迟、工作记忆容量降低等特征然而,现有文献中关于双眼视与执行能力之间关系的研究,特别是基于神经机制及其临床影响的系统性分析仍显得相对不足。为此,本文通过对现有研究的综述,深入探讨双眼视在执行能力中的作用,详细分析其背后的神经机制,并讨论这些发现对临床实践可能产生的影响。此外,文章还提出了未来研究的方向,以期更全面地理解双眼视与执行能力之间复杂的交互关系,从而为相关领域的研究提供新的视角和思路,推动这一领域的进一步发展。

Binocular vision, the ability of both eyes to work simultaneously, coordinate, and integrate visual information, can produce a unified, three-dimensional, and depth-perceptive visual experience. In recent years, it has garnered increasing attention in cognitive psychology and neuroscience research, particularly in exploring its complex relationship with executive functions. Executive functions, as a crucial cognitive capability, encompass various aspects, including attention, working memory, decision-making, and problem-solving, all of which collectively influence an individual's performance and efficiency in daily life and work. Current research indicates that binocular vision plays a key role not only in processing visual information but also has a significant impact on an individual's executive functions. Groups with binocular vision abnormalities (such as strabismus and amblyopia patients) generally exhibit characteristics like delayed response inhibition and reduced working memory capacity in executive function tests. However, existing literature on the relationship between binocular vision and executive functions, especially systematic analyses based on neural mechanisms and their clinical implications, remains relatively insufficient. Therefore, this article reviews existing research to delve into the role of binocular vision in executive functions, analyzes the underlying neural mechanisms in detail, and discusses the potential clinical implications of these findings. Additionally, the article proposes future research directions to comprehensively understand the complex interplay between binocular vision and executive functions, aiming to provide new perspectives and ideas for research in related fields and promote further development in this area.

综述

新型纳米材料介导治疗念珠菌角膜炎研究进展

Research progress on novel nanomaterials mediated treatment of candidal keratitis

:348-354
 

真菌性角膜炎是我国常见的致盲性眼病,其中排前3位的致病病原菌分别为曲霉菌、镰刀菌以及念珠菌。念珠菌作为一种条件致病真菌,在宿主免疫功能低下或眼表微环境失衡时易引发机会性感染,其发病率因免疫抑制药物的滥用以及隐形眼镜佩戴的增加等因素逐年上升。在机会感染后,由于念珠菌本身以及生物膜形成的特殊作用,常导致其对现用系统性抗真菌药物,如伏立康唑、两性霉素B、伊曲康唑及氟康唑等耐药性增加。近年来,关于纳米材料介导的药物传递系统作用于治疗念珠菌角膜炎的研究日益增多,新型纳米材料通过作为抗真菌药物的载体,增加药物溶解度,延长眼表停留时间,加强生物膜、角膜穿透性,提高了抗真菌药物对念珠菌的抗菌作用,为解决念珠菌感染耐药性难题提供了新思路。文章综述了纳米聚合物、纳米颗粒、纳米凝胶、脂质体载体、纳米立方体、纳米微针和纳米胶束等新型纳米材料作为治疗念珠菌角膜炎的新型给药载体的研究现状与进展,突破传统疗法的局限,为改善目前临床存在抗真菌治疗药物有限的问题提供新的可行思路。

Fungal keratitis is a prevalent blinding ocular disease in China, with Aspergillus, Fusarium, and Candida ranking as the top three pathogenic fungi. As an opportunistic pathogenic fungus, Candida readily causes opportunistic infections when host immunity is compromised or the ocular surface microenvironment is imbalanced. The incidence of Candida keratitis has been rising annually due to factors such as the misuse of immunosuppressive drugs and increased contact lens wear. Following infection, Candida itself and the formation of biofilms contribute to enhanced resistance against currently used systemic antifungal agents, including voriconazole, amphotericin B, itraconazole, and fluconazole, posing significant challenges to clinical treatment.Recently, research on nanomaterials-mediated drug delivery systems for treating Candida keratitis has burgeoned. Novel nanomaterials, serving as carriers for antifungal drugs, enhance therapeutic efficacy by improving drug solubility, prolonging ocular surface retention time, penetrating biofilms, and enhancing corneal permeability. These advancements offer new strategies to address drug resistance in Candida infections. This article reviews the research status and progress of emerging nanomaterialssuch as nanopolymers, nanoparticles, nanogels, liposomal carriers, nanocubes, nanoneedles, and nanomicellesas innovative drug delivery vectors for Candida keratitis. By overcoming the limitations of conventional therapies, these nanomaterials provide feasible solutions to the clinical challenges of limited antifungal options and drug resistance. The integration of nanotechnology holds promise for revolutionizing the treatment of Candida keratitis and advancing precision medicine for ocular surface fungal infections.

论著

压核进钩劈核技术在白内障手术培训中的应用研究

A study of the press-and-chop technique in cataract surgery training

:340-347
 

目的:探讨压核进钩劈核技术在白内障超声乳化摘除手术培训中的应用效果。方法:采用回顾性研究。选取2019年1月—2023年12月在广东省中医院珠海医院眼科学习超声乳化白内障吸除术的30名学员为研究对象,所有对象培训周期均为3个月,分为乳化劈核教学组和压核进钩劈核教学组,统计学员第一次完成劈核前的猪眼手术量、第一次完成全部手术步骤前的猪眼手术量、一次性完整完成二分核的次数,培训结束时对学员进行猪眼手术操作考核并记录评分,采用问卷调查对两种教学方式进行评价。结果:压核进钩劈核教学组第一次完成劈核前的平均猪眼手术量为36.69(19,50)个,低于乳化劈核教学组的49.86(29,66)个(U=-3.08,P<0.05);压核进钩劈核教学组第一次完成全部手术步骤前的平均猪眼手术量为58.13(31,79)个,低于乳化劈核教学组73.14(50,90)个(U=-2.66,P<0.05);压核进钩劈核教学组一次性完整完成二分核的次数为14.75(9,22)次,高于乳化劈核教学组6.79(3,14)(U=4.02,P<0.05);压核进钩劈核教学组学员动物眼手术碎核步骤平均分为4.50(3,5),高于乳化劈核教学组的3.71(2,5)次(U=2.23,P<0.05);完整手术考核总分平均分为29.00(23,33)分,高于乳化劈核教学组的23.07(19,28)分(U=3.98,P<0.05)。培训结束时,压核进钩劈核教学组学员评价教学效果调查问卷总评分平均为18.31(15,20)分,高于乳化劈核教学组15.07(12,18)(U=3.69,P<0.05)。结论:核进钩劈核技术有助于学员更快地掌握碎核技术,缩短白内障超声乳化摘除手术的学习曲线,增强学习白内障手术的信心,提高超声乳化白内障吸除术的教学效果和满意度。

Objective:To investigate the effect of the press-and-chop technique in cataract phacoemulsification training. Methods:From January 2019 to December 2023, 30 trainees who studied cataract phacoemulsification surgery in the ophthalmology department of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai were selected as the research subjects. The training period for all subjects was 3 months, and they were divided into two groups: phaco-chop teaching group and press-and-chop teaching group. The quantity of porcine eye surgeries performed by each trainee before completing the first nuclear chopping, the quantity of porcine eye surgeries performed before completing all surgical steps for the first time, and the number of times of complete nuclear chopping in one attempt were recorded. At the end of the training, the trainees were assessed on their ability to perform porcine eye surgeries and their scores were recorded. A questionnaire survey was conducted to valuate the two teaching methods. Results:The average number of porcine eye surgeries performed by the press-and-chop teaching group before completing the first nuclear chopping was 36.69 (19,50), which was lower than the phaco chop teaching group's 49.86 (29,66);The average number of porcine eye surgeries performed by the press-and-chop teaching group before before the first completion of all surgical steps was 58.13 (31, 79), which was lower than the phaco chop teaching group's 73.14 (50, 90).The average number of complete nuclear chopping in one attempt in the press-and-chop teaching group was 14.75 (9,22), which was higher than the phaco chop teaching group's 6.79 (3,14);The average score of the chopping step of porcine eye surgery for the press-and-chop teaching group was 4.50 (3,5), which was higher than the phaco chop teaching group's 3.71 (2,5);The average score for the press-and-chop teaching group of the complete surgery examination was 29.00 (23, 33), which was higher than the phaco chop teaching group's 23.07 (19, 28).At the end of the training, the average score of the survey questionnaire on the evaluation of teaching effectiveness by the press-and-chop teaching group was 18.31 (15, 20), which was higher than that of the phaco chop, which was 15.07 (12, 18). Conclusions:The press-and-chop technique helps trainees to master the chopping technique faster, shorten the learning curve of cataract phacoemulsification surgery, enhance confidence in learning cataract surgery, and improve the teaching effectiveness and satisfaction of cataract phacoemulsification surgery

论著

基于 OpenFDA 数据库的盐酸环喷托酯滴眼液不良反应信号检索与分析

Retrieval and analysis of cyclopentolate hydrochloride eye drops related adverse drug reaction signals based on OpenFDA

:331-339
 

目的:利用美国食品药品监督管理局公共数据开放项目(OpenFDA)检索并分析盐酸环喷托酯滴眼液药品不良反应adverse drug reactionsADRs的报告情况,为临床安全用药提供参考 方法: 盐酸环喷托酯滴眼液作为检索词,在OpenFDA数据库中检索200411日至202481日期间盐酸环喷托酯滴眼液相关ADRs的所有信息,对检索到的数据进行分析。 结果:共检索到盐酸环喷托酯滴眼液相关ADRs 11851185患者中,剔除性别不详,女性男性分别为516和48343.54% vs 40.76%;剔除年龄不详后,ADRs发生率较高的是65~<80患者221例,18.65%50~<65患者176例,14.85%3~<13患者140例,11.81%)。盐酸环喷托酯滴眼液发生率较高ADRs眼器官疾病(767例,64.73%神经系统疾病(254例,21.43%及胃肠系统疾病(228例,19.24% 结论:盐酸环喷托酯滴眼液可发生眼局部和全身ADRs临床在使用时应详细询问患者疾病史和用药史,加强用药监护,提高患者用药的安全性。

Objective: To retrieve and analyze adverse drug reactions (ADRs) of cyclopentolate hydrochloride eye drops on the US Food and drug Administration Public Data Open Project (OpenFDA), so as to provide reference for clinical rational drug use. Methods: Using "Cyclopentolate hydrochloride eye drops" as the search term, retrieve all information related to ADRs of cyclopentolate hydrochloride eye drops from the OpenFDA database from January 1, 2004 to August 1, 2024, and analyze the retrieved data  Results: A total of 1 185 cases of ADRs associated with cyclopentolate hydrochloride eye drops were found. Among the 1185 patients, 516 were female and 483 were male ( 43.54 % vs 40.76 % ) after excluding the unknown gender. After excluding patients with unknown age, the incidence of ADRs was higher in patients aged 65~ < 80 years old ( 221 cases, 18.65 % ), 50~< 65 years old ( 176 cases, 14.85 % ), and 3~ < 13 years old ( 140 cases, 11.81 % ). The ADRs with high incidence of cyclopentolate hydrochloride eye drops were ocular organ diseases ( 767 cases, 64.73 % ), nervous system diseases ( 254 cases, 21.43 % ) and gastrointestinal system diseases ( 228 cases, 19.24 % ). Conclusions: Cyclopentolate hydrochloride eye drops can cause local and systemic adverse reactions. In clinical use, the patient 's disease history and medication history should be asked in detail, and medication monitoring should be strengthened to improve the safety of patient medication.

其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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