论著

八年制临床医学生对眼科学直播课堂的满意度及教学效果调查

Survey on the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom teaching on ophthalmology

:458-467
 
目的:调查八年制临床医学生对眼科学直播课堂的满意度及教学效果。方法:基于八年制临床医 学生的直播课堂教学体验视角,进行问卷调查、课堂测验及课程考试,问卷内容包括调查对象基 本情况、直播课堂教学评价及满意度3个部分。采用SPSS 20.0统计学软件进行数据分析。结果:共 92名学生完成了问卷调查,男37名,女55名,年龄为(22.9±0.71)岁。课堂内容、课堂资源、平台设 计、平台技术及学习交流5个纬度的得分为40.60±4.582、17.43±2.814、13.07±1.759、13.14±2.052、 20.82±2.685;其中,与线下课堂交流相似性、学习交流积极性2个子条目的得分最低,分别为 3.42±1.131、3.85±0.864,这二者具有相关性(r=0.276,P=0.008)。直播课堂满意度的总得分为 13.52±1.872,课堂内容对其有显著影响(P<0.001),标准化回归系数为0.687。相较于课前测验,课 测验成绩(65.9±11.4分)的提升差异具有统计学意义(P=0.033);但是与2013级相比,2015级学生的 课程考试成绩(72.6±7.0分)降低,差异有统计学意义(P=0.009)。结论:课堂内容对直播课堂教学满 意度具有重要影响,需要注意直播课堂与线下课堂交流方式的差异,改进学习交流的参与积极性, 以提升教学效果。
Objective: To investigate the satisfaction and teaching effect of 8-year program medical students in live-streamed classroom on ophthalmology. Methods Based on teaching experience of live-streamed classroofrom the perspective of the 8-year program medical students, a questionnaire survey, classroom tests and course examination were conducted. The content of the questionnaire includes 3 parts: the basic information of the respondents, evaluation of live-streamed classroom teaching and its satisfaction. The SPSS 20.0 statistical software was used for data analysis. Results: A total of 92 students completed the questionnaire survey, including 37 males and 55 females, aged (22.9±0.71) years. The sores of content, resource, platform design, platform technology and learning communication of live-streamed classroom were 40.60±4.582, 17.43±2.814, 13.07±1.759, 13.14±2.052 and 20.82±2.685, respectively. Among all items, the scores of the similarity of offline classroom communication styles and enthusiasm for communication were lowest, with the points of 3.42±1.131 and 3.85±0.864, respectively, and the correlation of the two items were statistically significant (correlation coefficient =0.276, P=0.008). The total score of the live-streamed classroom satisfaction was 13.52±1.872. The classroom content has a significant effect on the satisfaction of the live-streamed classroom (P<0.001), and the standardized regression coefficient is 0.687. Compared with the pre-class test, the post-class test score was 65.9±11.4, with a statistically significant improvement (P=0.033); however, compared with grade 2013, the course test score of the students of grade 2015 was 72.6±7.0, with a statistically significant reduction (P=0.009). Conclusion: The classroom content has an important impact on the satisfaction of live-streamed classroom teaching. It is necessary to pay attention to the communication difference between live -streamed classroom and offline classroom settings, and improve the enthusiasm for participation in the study communication, in order to improve the effectiveness of teaching. 
眼底影像专栏

一站式玻璃体腔注药中心成立前后效果评价

The evaluation of the effects before and after the establishment of a one-stop intravitreal injection center

:252-260
 
目的:探讨一站式玻璃体腔注药中心成立前后不同管理模式下的成效,分析其对患者就医时间和就医体验的影响。方法:采用回顾性临床研究。选择2023年1月—2024年3月在汕头大学·香港中文大学联 合汕头国际眼科中心接受玻璃体腔注药的2955例患者纳入研究。将2023年1月—2023年8月玻璃体腔注 药中心成立前接受玻璃体腔注药的1399例患者作为对照组;2023年9月—2024年3月玻璃体腔注药中心成立后接受玻璃体腔注药的1556例患者作为观察组。对照组采用常规日间手术流程,观察组成立一 站式玻璃体腔注药中心,优化诊疗和护理服务流程。通过使用问卷调查比较两组患者就医期间从预约手术、手术当天到术后复查各节点的等待时间、健康教育知晓率、患者满意度及不良事件发生率的差异。结果:问卷调查结果显示,对照组、观察组患者间预约等待手术时间分别为(3.93±2.98) d、 (1.34±2.38) d,手术时间分别为(2.53±2.11) min、(1.93±1.82) min,在院时间分别为(313.62±184.96) min、(85.43±34.14) min,术后复查耗时分别为(45.92±48.44) min、(25.82±16.21) min,差异均有统计学意义(P<0.001);患者的总体健康教育知晓率成立前后分别为(95.50%、98.70%),差异有统计学意义 (χ2 =16.09,P<0.001);患者满意度调查结果显示,各项就医体验选项“非常满意”的占比成立后比 成立前明显提高。结论:一站式玻璃体腔注药中心护理模式简化了就医流程,极大地减少了患者就医期 间从预约手术、手术当天到术后复查各节点的等待时间、可显著提升工作效率,明显改善患者整体就 医体验。

To explore the application effects of different nursing models before and after the establishment of a one-stop intravitreal injection center, and to analyze their impact on patient's medical time and experience. Methods: A retrospective clinical study was conducted. From January 2023 to March 2024, 2955 patients who received anti-VEGF drug treatment at the Shantou International Eye Center, a joint initiative of Shantou University and the Chinese University of Hong Kong, were included in the study. The 1399 patients who received anti-VEGF drug treatment before the establishment of the intravitreal injection center from January 2023 to August 2023 were set as the control group; the 1556 patients who received anti-VEGF drug treatment after the establishment of the intravitreal injection center from September 2023 to March 2024 were set as the observation group. The control group followed the routine day surgery process, while the observation group established a one-stop intravitreal injection center to optimize the diagnosis, treatment, and nursing service process. A questionnaire survey was used to compare the differences in waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, health education awareness rate, patient satisfaction, and adverse event rate between the two groups. Results: The questionnaire survey showed that the waiting time for surgery between the control group and the observation group was (3.93±2.98) d, (1.34±2.38) d, respectively, the surgery time was (2.53±2.11) min, (1.93±1.82) mi, the in-hospital time was (313.62±184.96 min, 85.43±34.14) min, and the postoperative review time was (45.92±48.44) min, (25.82±16.21) min, with all differences being statistically significant (P <0.001); the overall health education awareness rate before and after the establishment was (95.50%, 98.70%), with a significant difference (P <0.001, χ2=16.09); the patient satisfaction survey showed that the proportion of "very satisfied" in various medical experience options was significantly higher after the establishment than before. Conclusions: The one-stop intravitreal injection center nursing model has simplified the medical process, greatly reducing the waiting time at various points from appointment to surgery, on the day of surgery, and postoperative review, significantly improving work efficiency, and significantly improving the overall medical experience of patients.

论著

胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果及眼表情况

Long-term Efficacy and Ocular Surface of Pterygium Excision Combined with Autologous Corneal Limbal Stem Cell Transplantation in Treatment of Pterygium

:101-105
 
目的:探讨胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果。
方法:2003年12月-2008年12月在我院就诊的原发性翼状胬肉患者55例57眼,均采用胬肉切除联合自体角膜缘干细胞移植治疗,术后随访2~8年,平均5.3年。观察创面愈合情况、治疗效果和并发症情况。
结果:术后早期患者均有不同程度的充血、水肿和异物感,3~5d 后症状逐渐减轻,一周左右完全消失。角膜创面完全上皮化时间为4~7d,平均4.83d。术后有持续性眼表刺激症状者7例,术后残留纤维组织者1例,角膜浅层瘢痕者4例。术后随访2~8年,平均5.3年,复发8例8眼 (复发率13.11%)。术后1年时复查OSDI 评分,所有患者较术前评分均有不同程度的降低,与术前相比,两组评分和构成比差异有统计学意义(P<0.05)。术后5年时复查OSDI评分较1年前稍有降低,但差异没有统计学意义(P>0.05)。术后1、5年时泪液基础分泌[(12.95±4.03) mm,(12.68±4.77) mm]和泪膜破裂时间 [(10.55±4.13)s, (10.03±4.64) s] 较术前[(9.48±3.34)mm,(8.14±3.57)s] 明显改善,差异有统计学意义(P<0.05)。
结论:应用胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉,术后早期症状轻、消失快,远期复发少,效果良好。
Purpose: To evaluate the long-term efficacy of pterygium excision combined with autologous corneal limbal stem cell transplantation in the treatment of pterygium.
Methods: Fifty five patients (57 eyes) diagnosed with primary pterygium undergoing pterygium excision combined with autologous corneal limbal stem cell transplantation between December 2003 and December 2008 were enrolled in this study. Postoperative follow-up endured for 2-8 years, 5.3 years on average. The wound healing, clinical efficacy and postoperative complications were observed.
Results: During early stage after surgery, all patients presented with varying degree of hyperemia, edema and sense of foreign body, which were gradually mitigated 3-5 d later and completely recovered in approximately 1 week. The corneal wound was completely epithelized within 4-7 d, 4.83 d on average. Seven patients had persistent ocular surface irritation symptoms after surgery, one case had residual fibrous tissues and four patients developed superficial corneal scars. Postoperative follow-up endured for 2-8 years, 5.3 years on average. Eight patients (8 eyes) recurred with a recurrence rate of 13.11%. In all patients,  postoperative OSDI score was significantly decreased at 1-year reexamination. OSDI score and constitution ratio significantly differed between two groups (both P<0.05).At postoperative 5 years, OSDI score was slightly lower compared with that in last year with no statistical significance(P>0.05).At post operative 1- and 5-year, basic tear secretion was (12.95 ±4.03) mm and (12.68 ±4.77) mm, tear film break-up time was (10.55±4.13)s and (10.03±4.64)s. Both indexes were significantly improved compared with (9.48±3.34) mm and (8.14±3.57)s before surgery (all P<0.05).
Conclusion: Pterygium excision combined with autologous corneal limbal stem cell transplantation is an efficacious treatment of pterygium with mild postoperative symptoms, rapid recovery, low long-term recurrence rate and high efficacy. 
论著

眼科住院医师委托培养效果的评估研究

Study of the effectiveness of entrusted standardized training for ophthalmic residents

:251-258
 
目的:住院医师委托培养是我国医学教育标准化和国际化的重要举措。本研究采用客观考核和主观问卷两种方法评估我国眼科住院医师委托培养效果。方法:本研究对象为广东省深圳市政府于
2012年8月至2015年7月期间委托中山大学中山眼科中心进行眼科住院医师规范化培训的9名学员。本研究对所有学员的基本信息、临床培训情况、以及考核成绩等客观指标进行统计分析,同时设 计了一份包含13个问题的调查问卷,对每位学员的培训情况进行主观评估。结果:本研究纳入9名研究对象,包括2名男性和7名女性,平均年龄为(26±3)岁,学历水平情况为学士7名和硕士2名,其中有7名毕业于国家重点医学院校。3年内人均轮转眼科亚专科超过10科,平均主管病人数及参加手术例数分别为736和1 219例,门诊工作总量人均6 274人次,所有学员均按规定至少完成综 述1篇。8名(88.89%)学员认为可以独立诊断并治疗大部分常见眼科疾病,而且能独立完成大部分眼科基本临床操作,5名(55.56%)学员可以单独完成翼状胬肉切除术、霰粒肿刮除术、前房穿刺术等。6名(66.67%)学员认为培训时间安排合理。8名(88.89%)学员对这次委托培养总体比较满意。 所有9名培训学员中,最终有7名(77.8%)顺利通过中山大学第一阶段住院医师规范化培训考核。结论:培训学员对现行的眼科住院医师规范化培训方案的接受程度较高,基本达到预期的培训效果,对常见眼病能独立进行诊治。委托培养学员的学历和学习能力的差异在一定程度上影响了最终的培训考核通过率。
Objective: The entrusted standardized training for residents is an important measure to gear the medical education in China to the international conventions. In this study, the effectiveness of standardized training for entrusted ophthalmic residents in China was evaluated both objectively and subjectively. Methods: Nine ophthalmic residents, commissioned by Shenzhen government of Guangdong Province, studied at Zhongshan Ophthalmic Center, Sun Yat-sen University during August 2012 to July 2015 were included in this study. The objective indicators of all participants were analyzed, including the basic information, clinical training, the score of examination, etc. The subjective self-assessment was also implemented thought a questionnaire including 13 designed questions.Results: All 9 participants included 2 males and 7 females, 2 medical masters and 7 bachelors, and the mean age was 26±3 years. Seven of them graduated from the national key medical universities. The mean number of rotated sub-clinical departments was 10.3, the mean number of managed inpatients and the participated operations were 736 and 1,219, respectively. The total number of managed outpatients was 6,274 in average. All participants completed at least one review article. Eight (88.89%) participants could independently diagnose and treat the most common ophthalmic diseases, they also could complete the basic clinical ophthalmic operation independently. Five (55.56%) participants could independently manage the pterygium excision, curettage of chalazion, anterior chamber penetration, etc. And 6 (66.67%) of the participants believed that the training length was reasonable. Eight (88.89%) of them were satisfied with the standardized training for residents on the whole. Finally, 7 participants successfully passed the first stage of standardized training program in Sun Yat-sen University. Conclusion: There was a high level acceptance rate of the standardized training programs for entrusted ophthalmic residents. The participants achieved the expected training effects, and could managed the diagnosis and treatment of common ophthalmic diseases independently. But the training effects and passing rate of examination were partly affected by the learning ability of the training students.

Acrysof IQ Restor多焦点Toric人工晶状体植入术后临床效果观察

The clinical effects of implantation of Acrysof IQ Restor multifocal Toric lens

:98-102
 
目的:评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜 散光的早期临床效果、安全性,以及术后人工晶状体眼的视功能状态。方法:搜集自2013年至今 在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼) 进行分析,术前患者散光均大于1.0 D。术后随访3个月,分别观察术后1周、1个月以及3个月的裸眼远视力,最佳矫正远视力以及裸眼近视力,术前散光以及术后3个月时残余散光、等效球镜度数 和人工晶状体的旋转度。结果:术后3个月患者裸眼远视力0.89±0.21,最佳矫正远视力0.95±0.38, 等效球镜为?0.5~+0.25D,裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D,较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论:Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质 量,并校正了术前角膜散光,实现了患者高度满意率和脱镜率,可预测性好,并有良好的旋转稳定性。
目的:评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜 散光的早期临床效果、安全性,以及术后人工晶状体眼的视功能状态。方法:搜集自2013年至今 在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼) 进行分析,术前患者散光均大于1.0 D。术后随访3个月,分别观察术后1周、1个月以及3个月的裸眼远视力,最佳矫正远视力以及裸眼近视力,术前散光以及术后3个月时残余散光、等效球镜度数 和人工晶状体的旋转度。结果:术后3个月患者裸眼远视力0.89±0.21,最佳矫正远视力0.95±0.38, 等效球镜为?0.5~+0.25D,裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D,较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论:Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质 量,并校正了术前角膜散光,实现了患者高度满意率和脱镜率,可预测性好,并有良好的旋转稳定性。

OCT对激光周边虹膜切开术治疗原发性闭角型青光眼效果的评价

Evaluation of the effect of OCT in the treatment of primary angle closure glaucoma by laser peripheral iris

:103-106
 
目的:通过光学相干断层扫描技术(optical coherence tomography,OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化,评价治疗效果。方法:选择明确诊断为PACG患者46例50眼,其中 急性闭角型青光眼临床前期及缓解期眼26例27眼,慢性闭角型青光眼20例23眼,行LPI治疗,通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离,采用配对t检验。结果:急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05);慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论:急性闭角型青光眼LPI术后前房角开放距离增加,治疗效果较好;慢性闭角型青光眼LPI术后前房角开放距离增加不明显,术后仍存在前房角闭塞趋向。
Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.
论著

EYESi模拟器结合Wet-lab在白内障手术培训中的效果评价

Effect evaluation of EYESi simulator combined with Wet-lab in cataract surgery training

:736-745
 
目的:比较单一EYESi虚拟手术模拟器(Dry-lab)、Wet-lab以及两种方式联合教学在超声乳化白内障吸除显微手术培训中的效果及差异,以期探索更科学高效的教学方式。方法:选取中山大学中山眼科中心接受住院医师规范化培训的1年级住院医师18名,随机分为Dry-lab组、Wet-lab组和联合组,每组各6人,分别接受8次有效Dry-lab训练、8次Wet-lab训练、4次有效Dry-lab训练联合4次Wet-lab训练。培训前后问卷调查评估三种教学方式的模拟效果与学员满意度,并在猪眼模型上考核超声乳化白内障吸除手术的三个主要步骤,以评估学员的培训效果。结果:Dry-lab与Wet-lab训练均能有效帮助学员学习使用显微器械,操作手感较好。但在立体感(P=0.007)、与人眼操作相比近似度(P<0.001)以及对掌握技术的帮助度(P=0.003)上,Wet-lab优于Dry-lab训练;而在缩短培训用时(P<0.001)上,Dry-lab培训更具优势。联合培训模式培训效果优于单一Wet-lab训练(P=0.014)和模拟器培训(P=0.012),整体满意度高于Wet-lab训练(P=0.042)和Dry-lab培训(P=0.042)。结论:Dry-lab与Wet-lab训练在超声乳化白内障吸除显微手术培训中各有优势,而两者相结合的教学模式更为高效,培训效果更佳,整体满意度高。
Objective: To compare the effects and distinctions among three methods of phacoemulsification training: EYESi simulator (Dry-lab), Wet-lab, and a combined approach, in order to find out more scientific and efficient teaching method. Methods: 18 first-year residents undergoing residency training at Zhongshan Ophthalmic Center, Sun Yatsen University were randomly assigned to three groups: Dry-lab, Wet-lab, and Combined. Each group, consisting of 6 individuals, underwent a specific training regimen—8 sessions of effective simulator training for the Dry-lab group, 8 Wet-lab sessions for the Wet-lab group, and a combination of 4 effective simulator sessions with 4 Wet-lab sessions for the Combined group. The questionnaires were administered to assess simulation effects and student satisfaction before and after each training sessions. Additionally, the training effects were recorded in the three main steps of phacoemulsification cataract extraction surgery on a pig eye model. Results: Both the EYESi simulator and Wet-lab were proved to be effective in facilitating the learning of microscopic instrument use with commendable operating experience. However, Wet-lab is superior to the virtual simulator in terms of stereoscopic sensation (P=0.007), similarity to the human eye (P<0.001), and assistance in mastering techniques(P=0.003). Simulator training is found to be more advantageous in shortening the overall training time (P<0.001). The training effect of the joint training mode is better than that of single Wet-lab training (P=0.014) and simulator training (P=0.012), and the overall satisfaction is higher than that of Wet-lab training (P=0.042) and simulator training (P=0.042). Conclusion: The EYESi virtual surgery simulator and Wet-lab training have their advantages respectively in training for phacoemulsification cataract extraction microsurgery, and the combined teaching mode is more efficient, with better training effects and overall satisfaction.
医学教育

基于眼科住院医师规范化培训学员视角的睑板腺囊肿诊疗培训效果调查

Training effectiveness survey of diagnosis and treatment for chalazion from ophthalmology trainees’ perspective in resident standardized training

:913-920
 
目的:探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题,以期改进培训方式。方法:以2020年4月在中山大学中山眼科中心培训的154名学员为对象,进行问卷调查,采用SPSS 20.0统计学软件进行数据分析。结果:共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%;住培则显著高于前者,分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断,90.8%的专硕选择了临床诊断(P=0.007),94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001);而住培仅为去除囊壁(P<0.001)。结论:睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高,并根据各类型学员的临床能力和认知差异,进行分级分类培训。
Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.
论著

基于Base-out恢复点为目标手术量的急性共同性内斜视手术效果

Surgical effect of acute concomitant esotropia based on base-out recovery point as target operation volume

:192-199
 
目的:探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia,AACE)的治疗效果。方法:随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者,分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果:将43例患者纳入研究,其中男27例(63%),女16例(37%),手术年龄9~53(23.7±11.4)岁,术前斜视持续时间3个月~11年(24.8±24.5个月),术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD,P<0.001;近距差值(11.4±6.7) PD,P<0.001];术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD,末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001),38例(88%)患者无眼位偏斜,5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001),末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论:以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果,未见眼位过矫者;术后立体视恢复与术前近距立体视和术前斜视持续时间相关,提示适当早期手术可能有助于术后立体视功能的恢复。
Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.
论著

耳穴压豆预防眼底荧光血管造影胃肠反应的效果观察

Efficacy of auricular points plaster therapy on preventing gastrointestinal reaction caused by fundus fluorescein angiography

:144-148
 
目的:探讨耳穴压豆疗法预防眼底荧光血管造影(fluorescence fundus angiography,FFA)胃肠反应的效果。方法:选取2019年10月至2020年4月在汕头大学·香港中文大学联合汕头国际眼科中心特殊检查科行眼底荧光素血管造影检查的患者583例,实验组298例,对照组285例。对照组在检查前予常规护理措施。试验组检查前在对照组的基础上实施耳穴压豆疗法。比较两组受检者在检查期间的胃肠道反应情况及配合度和舒适度的区别。结果:试验组胃肠道反应发生率低于对照组(P<0.05)。配合度得分试验组为(2.87±0.35)分,对照组为(2.96±0.19)分,两组差异有统计学意义(P<0.001)。舒适度得分试验组为(3.93±0.70)分,对照组为(3.91±0.56)分,两组差异无统计学意义(P=0.122)。结论:耳穴压豆疗法可以降低FFA检查胃肠道反应发生率,疗效安全可靠,操作简便易行,另外,耳穴压豆方法不会造成患者检查时舒适度下降,有助于患者顺利安全完成检查。
Objective: To explore the prevention efficacy of auricular points plaster therapy on gastrointestinal reaction caused by fundus fluorescein angiography (FFA). Methods: We selected 583 patients who underwent fundus fluorescein angiography in the special examination department of our hospital from October 2019 to April 2020, and divided these patients into experimental group (n=298) and control group (n=285). The control group was given routine nursing measures before the examination. The experimental group was treated with auricular points plaster therapy on the basis routine nursing measures before the examination. The gastrointestinal reactions, degree of patient compliance and comfortableness during the examination were compared between the two groups. Results: The incidence of gastrointestinal reaction in the experimental group was lower than that of control group (P<0.05). The score of patient compliance degree was 2.87±0.35 in the experimental group and 2.96±0.19 in the control group, and there was a significant difference between the two groups (P<0.001). Degree of comfortableness was 3.93±0.70 in the experimental group and 3.91±0.56 in the control group. There was no significant difference between the two groups (P=0.122). Conclusion: Auricular points plaster therapy can reduce the incidence of gastrointestinal reaction caused by fundus fluorescein angiography, which is safe and reliable, easy to operate. In addition, the auricular points plaster therapy will not affect patient’s comfortness during examination, and will comply the patients to the examnination smoothly. is helpful for patients to complete the examination comfortably and safely
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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