眼科医院多院区运维一体化信息系统设计和实现

Design and implementation of integrated information system for operation and maintenance in two hospital districts of Zhongshan Ophthalmic Center

:271-278
 
目的:利用信息化手段强化整合医院医疗后勤、物业和设备终端日常维护管理工作,实现临床后勤保障和设备终端运维服务工作闭环管理。方法:使用微信搭建医院快速报修信息系统,通过微信公众号向临床、科研和后勤管理部门,提供信息设备、医疗设备及后勤物业等快速报修服务。结果:建立眼科医院运维一体化信息系统,满足维修有申请、巡检有记录和服务有评价的运维服务标准,实现运维数据统计分析及工作量报表功能。结论:眼科医院多院区运维一体化信息系统有效提高了运维工作质量,优化了医院运维管理流程,更好地满足了日间手术、日间病房等眼科医院快速医疗服务要求。

Objective: To integrate the hospital logistics, property and information terminal maintenance and achieve operational service closed-loop management, relying on the information construction in Zhongshan Ophthalmic Center, China. Methods: We used WeChat to provide fast repair service covering information equipment, medical equipment and logistics services. Results: Information system realized the function of application maintenance, record inspection and evaluation services, completed the statistical analysis of operation and maintenance data and the reporting features. Conclusion: Information system can effectively improve the operational quality, optimize the process of hospital operational management and meet the requirements of offering rapid service in an ophthalmic hospital.

东莞市498例早产儿视网膜病变的筛查情况

Screening of retinopathy in 498 premature infants in Dongguan City

:267-270
 
目的:分析东莞市 498 例早产儿视网膜病变(retinopathy of prematurity,ROP)的筛查情况。方法:回顾性分析 2015 年 1 月至 2017 年 1 月在东莞市人民医院筛查的出生孕龄不足 34 周或体重不足 2 000 g 的早产儿,利用眼底筛查方法(RetCam II)对其视网膜病变进行筛查,对筛查结果进行概率分析。结果:早产儿的体重越轻,发生视网膜病变的可能性越大(χ2 = 86.90,< 0.0001);早产儿的胎龄越小,发生视网膜病变的可能性越大,(χ2 = 87.37,< 0.0001)。结论:早产儿的体重、孕龄与其视网膜病变存在十分密切的关系,对于体重偏轻、孕龄偏低的早产儿应定期进行眼底筛查。

Objective: To analyze the screening of retinopathy of 498 premature infants in Dongguan City. Methods: RetCam II was used to screen the retinopathy of premature infants with less than 34 weeks gestational age or less than 2 000 g weight in our hospital from January 2015 to January 2017. Results: The lighter the body weight of premature infants, the more likely they were to develop retinopathy (χ2=86.90, P<0.0001), and the smaller the gestational age of premature infants, the more likely they were to develop retinopathy (χ2=87.37, P<0.0001). Conclusion: The weight and gestational age of premature infants are closely related to retinopathy, and fundus screening should be carried out regularly for premature infants with low weight and low gestational age.

阿托品对单色光中豚鼠屈光发育的干预作用

Intervention effect of atropine on refractive development of guinea pigs in different monochromatic lights

:260-266
 
目的:研究阿托品作用下豚鼠眼在不同单色光中的屈光发育情况。方法:24 只 2 周龄 3 色种豚鼠被随机分成 3 组,分别在蓝光(430 nm)、绿光(530 nm)和白光(色温 5000k)中饲养。3 组豚鼠的双眼从实验开始点 1% 阿托品滴眼液,1 次/d,持续 6 周。实验前后测量豚鼠屈光度和眼球生物参数。 结果:实验开始时 3 组各测量结果差异均无统计学意义。实验起始时各组平均屈光度约为 4.3 D。实验结束时白光组平均屈光度约为 4.84 D,绿光组约为 3.47 D,蓝光组约为 6.19 D,3 组间屈光度差异显著,且 3 组前后屈光度变化量比较差异显著。各组玻璃体腔长度在实验开始约为 3.3 mm,实验结束时白光组约为 3.25 mm,绿光组约为 3.39 mm,蓝光组约为 3.17 mm。此时白光组与绿光组玻璃体腔长度相比差异显著,绿光组与蓝光组相比差异显著,而白光组与蓝光组相比差异无统计学意义。实验结束时 3 组角膜曲率半径、前房深度和晶状体厚度无统计学差异。结论:阿托品通过干预豚鼠玻璃体腔长度的变化而影响单色光对屈光发育的作用,但单色光引起的屈光变化方向不受影响。
Objective: To investigate the effect of atropine on ocular refractive development of guinea pigs in different monochromatic lights. Methods: Twenty-four guinea pigs aged 2 weeks were randomly divided into three groups, which were raised in blue light (BL, 430 nm), green light (GL, 530 nm) and white light (WL, color temperature 5000k), respectively. The two eyes of the guinea pigs in the three groups were treated with 1% atropine eye drops once a day for 6 weeks from the beginning of the experiment. The refraction and ocular biological parameters of the guinea pigs were measured before and after the experiment. Results: At the beginning of the experiment,there was no significant difference in every measurement among the three groups. The average refraction of each group was about 4.3 D at the beginning. At the end of the experiment, the average refraction was approximately 4.84 D in the WL, 3.47 D in the GL, and 6.19 D in the BL. The differences in refraction of the three groups were significant, and the refractive changes of the three groups before and after the experiment were significant. The length of vitreous chamber in each group was approximately 3.3 mm at the beginning, but it was approximately 3.25 mm in the WL, 3.39 mm in the GL and 3.17 mm in the BL at the end of the experiment. At this time, there was significant vitreous difference between the WL and the GL, and between the GL and the BL, but there was no significant difference between the WL and the BL in vitreous length. After the experiment, there was no significant difference in the radius of corneal curvature, depth of anterior chamber and lens thickness among the three groups. Conclusion: The effect of monochromatic light on refractive development is affected by atropine through intervening the vitreous length in guinea pigs, but the direction of refractive change induced by monochromatic light is not influenced.

泛格栅光凝联合光动力疗法、抗血管内皮生长因子药物治疗湿性年龄相关性黄斑变性的临床疗效

Clinical efficacy of triple therapy with pan-macular grid laser, photodynamic therapy, and anti-vascular endothelial growth factor in treatment of extensive wet age-related macular degeneration

:252-259
 

目的:探讨联合泛格栅光凝、光动力疗法(photodynamic therapyPDT)、抗血管内皮生长因子(vascular endothelial growth factorVEGF)药物对大范围湿性年龄相关性黄斑变性(age-related macular degenerationAMD)的临床疗效,探索对视力较差的湿性 AMD 的更经济的治疗手段。方法:将病灶范围 ≥ 1.5 DD、视力 < 0.3 的 AMD 患者分为试验组与对照组。试验组采用联合治疗,即先采用泛格栅光凝对一个大的脉络膜新生血管(choroidal neovascularizationCNV)病变或多个 CNV 病变的黄斑中心拱环外区域进行直接光凝,再对黄斑中心病变采用 PDT 治疗,最后在 PDT 治疗后 2 ~ 3 d 采用玻璃体腔注射抗 VEGF 药物。对照组(VEGF 组)采用标准的 3 + prn 抗 VEGF 药物注射治疗。评价治疗前后视力的变化情况、重复治疗次数等。结果:试验组 27 例,治疗次数(1.2 ± 0.47)次;对照组37例,治疗次数(3.4 ± 1.9)次,两组间治疗次数有显著差异,但两组治疗后视力比较无显著差异。结论:采用综合治疗方法,在大大减少治疗次数的前提下,能较好地保存患者的残存视力,具有较大的推广意义。

Objective: To evaluate the clinical efficacy of the combination of pan-macular grid laser, photodynamictherapy (PDT) and anti-vascular endothelial growth factor (VEGF) on a wide range of wet age-related macular degeneration (AMD), and to explore a more economical treatment method for wet AMD with low visual acuity. Methods: Patients with AMD with a range of lesions greater than 1.5 DD and visual acuity less than 0.3 were divided into the experimental group and the control group. In the experimental group, combined treatment was adopted, namely, a large choroidal neovascularization (CNV) lesion or multiple CNV lesions were treated by means of pan-macular grid laser directly in the outer area of the macular central arch, followed by the treatment of macular central lesions by PDT, and finally two to three days after the treatment of PDT, anti-VEGF drugs were injected into the vitreous cavity. In the control group (VEGF group), a standard 3+ prn anti-VEGF medication was administered. The changes in the visual acuity before and after the treatment were evaluated. Results: There were 27 cases in the experimental group, receiving (1.2±0.47) times of treatment on average, and 37 cases in the control received (3.4±1.9) times of treatment on average. Conclusion: The combined treatment can save the patient’s remaining vision and deserves widespread application, on the premise of significantly reducing the number of treatment.

眼科术前结膜囊细菌培养

Conjunctival bacterial flora culture before eye surgery

:173-176
 

目的:回顾性分析眼科手术前结膜囊细菌培养的阳性菌构成及药物敏感性。方法:选取 2016 年 月至 2018 年 月在武汉大学人民医院眼科中心住院的 3 205 例患者,按照入院疾病不同,分为 组行眼分泌物细菌培养,对阳性菌株和药敏结果进行统计分析。结果:3 205 例患者眼分泌物培养的阳性率为 8.33% 。其中白内障患者 1 435 例,阳性率为 9.13% 。青光眼、孔源性视网膜脱离患者总数分别为 870,900 例,阳性率分别为 10.11% 5.33% 。孔源性视网膜脱离组与白内障组P=0.0008)、青光眼组(P=0.0002)相比,差异均有统计学意义(P<0.05)。白内障与青光眼组相比,差异无统计学意义(P>0.05。细菌菌种的阳性株以革兰阳性细菌为多,占 77.90% ,其中表皮葡萄球菌最多,占革兰阳性菌的 66.83% 。药敏检查结果示绝大多数菌株都对红霉素耐药,对万古霉素、庆大霉素、阿米卡星敏感;对妥布霉素及环丙沙星的敏感性稍低。结论:术前常规结膜囊无菌化极为重要,尤其是眼前节手术(如青光眼、白内障)术前。

Objective: To analyze the conjunctival bacterial flora and antibiotic resistance pattern in the patients undergoing surgery. Methods: From January 2016 to 2018, 3 205 patients hospitalized in the Eye Center of Peoples Hospital of Wuhan University were divided into three groups according to the diseases. The preoperative conjunctival cultures and antibiotic susceptibility tests of 3 205 eyes were studied retrospectively. Results: Of 3 205 eyes, 267 8.33%) had positive cultures. The number of cases of cataract, glaucoma and retinal detachment was 1 435, 870 and 900, respectively and the positive rate was 9.13%, 10.11%, 5.33%. Statistical significance was observed in the retinal detachment patients compared with their counterparts with cataract and glaucoma both P<0.05. There was no statistically significant difference between the cataract and glaucoma groups P>0.05. Grampositive bacterium G+) (77.90%) was the most common bacterial isolate, mainly staphylococcus epidermidis 66.83%. Most of the strains were resistant to erythromycin, sensitive to vancomycin, gentamicin and amikacin.The sensitivity of tobramycin and ciprofloxacin was slightly lower. Conclusion: It is of significance to make preoperative conjunctival preparation, especially glaucoma and cataract patients.

白内障超声乳化联合植入Toric人工晶状体术后疗效

Postoperative efficacy of cataract phacoemulsification combined with implantation of Toric intraocular lens

:169-172
 

目的:探讨对伴有角膜散光的单纯白内障患者行白内障超声乳化联合植入 Toric 人工晶状体后,患者的视力、残余散光、人工晶状体偏转度等情况。方法:采用回顾性分析研究方法。选取 2015 年 12 月至 2017 年 月于解放军南京总医院行白内障超声乳化联合散光纠正型人工晶状体植入术的 45 例患者,术眼 47 只。分别测量患者术前的裸眼视力、最佳矫正视力、角膜散光度数以及手术后 个月的裸眼视力、最佳矫正视力、残余散光度数、人工晶状体偏移度数等。结果:47 例眼均手术成功。术前患者的裸眼视力为 0.71±0.33 logMAR,最佳矫正视力为 0.44±0.34 ;术后 个月,患者裸眼视力为 0.25±0.17 logMAR,最佳矫正视力为 0.17±0.16 logMAR),差异有统计学意义(P <0.01)。术前患者角膜散光为(2.82±0.73;术后 个月,患者的残余散光度数为0.41±0.26,较术前明显降低,差异有统计学意义P<0.05。术后 个月,患者人工晶状体轴向的偏转度为3.18±2.06)° 。结论:使用 Toric 人工晶状体治疗伴有角膜散光的白内障安全有效,术后可明显提高患者术后裸眼视力,术后残余散光度数小,可提高患者视觉质量。

Objective: To explore the vision, astigmatism, intraocular lens deflection and visual quality of cataract patients with corneal astigmatism after cataract phacoemulsification combined with Toric intraocular lens implantation. Methods: A retrospective systematic study method was used. From December 2015 to June 2017, a total of 45 patients 47 eyes) underwent cataract phacoemulsification combined with Toric intraocular lens implantation in Nanjing General Hospital. Uncorrected visual acuity UCVA, best corrected visual acuity BCVA) and astigmatism were measured before and 3 months after the operation. The intraocular lens axial was measured at 3 months after operation. Results: The surgery was successfully performed in 47 patients. The UCVA before operation was 0.71±0.33 logMAR, the BCVA was 0.44±0.34 logMAR; at 3 months after the operation, the UCVA was 0.25±0.17 logMAR, the BCVA was 0.17±0.16 logMAR, and the difference was statistically significant P<0.01. The astigmatism before operation was 2.82±0.73) D. The residual astigmatism at 3 months after operation was 0.41±0.26) D, which was significantly lower than that before operation P<0.05; at 3 months after the operation, the axial deflection of the intraocular lens was 3.18±2.06°. Conclusion: It is safe and effective to treat cataract patients with corneal astigmatism with Toric intraocular lens. After operation, it can significantly improve postoperative visual acuity and residual astigmatism of patients.

吴乐正教授:孜孜不倦,探索眼科医学新领域

:210-212
 

     【编者按】2019 国际眼科论坛:人工智能与人工视觉 2019 IOF-AIAV)  2019 5 24~26 日在深圳喜来登酒店成功举行。本次会议由亚非眼科学会、广东省医学会主办,中山大学中山眼科中心、深圳市眼科医院合办。现任亚非眼科学会主席吴乐正教授担任大会主席。来自中国、埃及、新加坡、韩国、美国等 14 个国家和地区的专家们出席了本次会议,围绕人工智能在眼科的应用,从人工智能与致盲眼病诊疗、医学影像及技术等多个方面展开学术交流与探讨。会议期间,我们有幸邀请到了吴乐正教授进行简单的采访与分享。

林浩添教授:人工智能与人工视觉——眼科防治“新赛道”

:206-206
 

     编者按:2019 国际眼科论坛:人工智能与人工视觉 IOF-AIAV)  2019 5 24 26 日在深圳圆满举行。本次论坛以“人工智能与人工视觉”为主题,邀请来自新加坡、韩国、印度、埃及、摩洛哥、突尼斯、巴基斯坦以及香港和台湾等亚非国家和地区的眼科领域的优秀专家学者,就人工智能的应用、眼科博览、人工智能与医疗、眼科大数据和智能医疗、人工智能与影像分析、人工智能与青光眼以及人工视觉等专题进行交流与分享。

专家访谈

苏国辉教授:光疗抗抑郁——光如何调节你的情绪?

:204-205
 

     编者按:2019 5 24 26 日,由亚非眼科学会、广东省医学会主办,中山大学中山眼科中心、深圳市眼科医院共同合办的“2019 国际眼科论坛:人工智能与人工视觉 IOF-AIAV”在深圳喜来登酒店顺利召开。本次论坛广邀国内外眼科和人工智能领域顶尖的专家学者一同交流探讨人工智能与眼科学的发展。会后,AME 出版社有幸邀请到苏国辉教授接受专访,苏教授就近来备受关注的光疗抗抑郁的神经机制、视神经再生以及人工智能在眼科学中的应用等话题发表个人看法。

泪小管断裂吻合手术的影响因素

Influencing factors of anastomosis of lacrimal canaliculus fracture

:164-168
 

目的:探讨泪小管断裂吻合手术影响因素,提高泪小管断裂吻合手术成功率。方法:选择齐齐哈尔市五官医院眼科治疗的泪小管断裂患者 126 例为研究对象,进行术前评估,术后总结分析吻合手术的影响因素及经验。结果:患者均一次性吻合成功,术后治愈 107 例,好转 14 例,无效 例,总有效率为 96.03% 例术后泪小管豁裂,例术后 周内泪道支撑管脱落,二期行泪小管修复手术及 RS 型泪道扩张引流管再次置入后均治愈。结论:泪小管断裂吻合手术前充分分析病情,术中吻合断裂的泪小管、正确处理眼睑裂伤口,加强围手术期护理均有利于提高手术成功率。

Objective: To investigate the influencing factors of anastomosis of lacrimal canaliculi and to improve the success rate of anastomosis. Methods: A total of 126 cases of lacrimal canaliculus fracture treated in Qiqihar Wuguan Hospital were selected, and the preoperative evaluation was carried out. The factors affecting the anastomosis and the operation experience were summarized and analyzed. Results: All cases were anastomosed successfully, 107 cases were cured, 14 cases were improved, 5 cases were not effectively treated and the total effective rate was 96.03%. Three patients suffered from postoperative lacrimal canaliculus laceration, two of them lost the lacrimal duct support tube within 1 week after surgery, which were cured after repeated lacrimal canaliculus anastomosis and the placement of the RS lacrimal duct drainage tube. Conclusion: Comprehensive analysis of lacrimal canaliculus fracture anastomosis before operation, anastomosis of tear canaliculus, effective treatment of eyelid cleft wound and strengthening perioperative nursing are beneficial to improve the success rate of operation.

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
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  • 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
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