医学教育

全眼模型在Wetlab眼科手术教学中的应用

Application of porcine orbit model in ophthalmic surgery teaching

:830-835
 
目前Wetlab眼科手术教学采用猪眼球作为教学模型,与实际手术差别较大,且无法满足外眼手术教学的需求。通过使用带有眼球、眼外肌、眶组织、眶骨及眼睑结构的全眼模型,可高度模拟真实手术场景,覆盖更多眼科手术教学需求。基于全眼模型构建多个眼科手术教学平台,依照培养阶段设计手术课程,创建新的评价体系,改变传统将“内眼”“外眼”分开的教学理念,可使年轻医师从一开始就建立眼科“分科而不分割”的整体思维,从而使眼科手术培训更加规范和完善。
Porcine eyes have been used as animal model in ophthalmic surgery training. However, it differs greatly from real surgery and cannot meet the needs of external eye surgery teaching. Porcine orbit model with eyeball, extraocular muscles, orbital tissue, bones and eyelids can be more realistic simulation of real surgeries and cover more needs for ophthalmic surgery teaching. By setting up ophthalmic surgery teaching platforms, designing staged course and creating new assessment methods based on porcine orbit model, the traditional concept about separation of internal and external eye is changed. This helps young doctors to establish a holistic view from the very beginning, that ophthalmic surgeries should not be split because of subspeciality. In this way, ophthalmic surgery training will become more standardized and perfected.
论著

赋能教育模式在干眼患者健康教育中的应用

Application of empowerment education mode in health education for patients with dry eye syndrome

:525-531
 
目的:探讨赋能教育模式在干眼患者健康教育中的应用价值。方法:选取2017年6月至12月期间首诊于南方医科大学珠江医院眼科的干眼患者,按照完全随机分配法分为试验组(n=73)及对照组(n=73),试验组采用赋能教育模式,对照组采用传统健康教育方式。经治疗1周、1个月、2个月及6个月后,分别随访并记录每组患者的眼表疾病指数(ocular surface disease index,OSDI)、泪膜破裂时间值(tear film break up time,BUT),同时记录患者家庭护理(清洁睑缘、热敷、睑板腺按摩)频率以及复诊频率。结果:赋能教育组家庭护理频率及复诊频率均优于传统教育组(P<0.05)。治疗前两组OSDI和BUT差异均无统计学意义(P>0.05),但试验组OSDI随时间的推移呈下降趋势,BUT值呈上升趋势;而对照组OSDI以及BUT值的变化均不明显。结论:运用赋能教育模式有助于提高干眼患者治疗的依从性,提高患者的家庭护理频率和复诊频率,显著改善患者的眼表情况,进而提高长期治疗效果。
Objective: To evaluate the application value of empowerment education mode in health education for patients with dry eye syndrome. Methods: Patients with dry eye syndrome were recruited from Department of Ophthalmology, Zhujiang Hospital, Southern Medical University from June 2017 to December 2017. All patients were randomly divided into the experimental group (n=73), educated with empowerment education mode, and control group (n=73), treated with traditional health education. Patients were followed up after 1 week, 1 month, 2 months and 6 months, respectively. Data were collected in each follow-up visit including ocular surface disease index (OSDI), tear film break up time (BUT), the frequency of home care (cleaning eyelid margin, hot compress, palpebral gland massage) and re-visit frequency. Results: The OSDI and BUT were similar between two groups before corresponding treatment (P>0.05). After the treatment, patients in the experimental group showed a downtrend in the OSDI and uptrend in the BUT. No significant changes were found in the control group during the follow-up. The frequency of family nursing and re-visit in the experimental group was statistically higher than that in the control group. Conclusion: The application of empowering education mode can improve the compliance of dry eye patients, improve the frequency of home care and follow-up visit, and mitigate the ocular surface of patients, thereby enhancing the long-term efficacy.
发明与创新

一种眼部化学伤结膜囊冲洗器

Application of conjunctiva sac irrigation device for ocular chemical injuries

:558-560
 
为满足眼部化学伤患者高效急救的需要,发明一种眼部化学伤结膜囊冲洗器,包括进液管道,冲洗管道,手动加压球,流量调节器和结膜囊冲洗头,避免反复更换冲洗液,减少操作时间,同时有利于冲洗液快速大量聚集,为严重眼部化学伤的患者缩短急救等待时间;手动加压球的设置,实现了冲洗液重力基础上的加压冲洗,为患者眼部急救治疗效果提供了可靠保证。
A new conjunctiva sac irrigation device which includs a liquid inlet pipe, flush pipe, and a manual pressure device, a flow regulator and a flush filter was invented to meet needs of efficient first aid for ocular chemical injuries. It is worth noting to avoid changing fushing fliud frequently and shorten time of operation, which is beneficial to gather a lot of flushing fluid in a short time and shorten the first aid waiting time for patients with severe ocular chemical injuries. For this device, the design of manual pressure ball realizes presure flush based on the gravity of flushing fliud, which confirms a reliable effect on the acute treatment to patients' eyes.
综述

2014—2019年北京同仁医院儿童青光眼住院患者的疾病构成特点

Analysis of disease constitution of pediatric glaucoma inpatients in Beijing Tongren Hospital from 2014 to 2019

:478-485
 
目的:了解儿童罹患青光眼的疾病类型、特点,更好地做到早期发现早期治疗。方法:收集北京同仁医院2014—2019年度834例0~18周岁住院接受抗青光眼手术的患者,回顾性分析患者的人群特点与疾病构成特点。结果:834例患者中,原发青光眼397例(47.6%),继发青光眼429例(51.4%)。另有8例无法明确诊断青光眼类型。原发青光眼中以原发先天性青光眼最常见,继发青光眼中以白内障术后继发青光眼为主,两种类型的青光眼占总患者数的50%。结论:儿童罹患青光眼的疾病种类繁多,其中原发先天青光眼与白内障术后继发青光眼最常见,重视婴幼儿先天青光眼的筛查,监测儿童白内障术后眼压有助于早期发现青光眼,并给予治疗,延缓儿童青光眼患者视功能的损害。
Objective: To understand the types and characteristics of glaucoma in pediatric inpatients to achieve early detection and treatment. Methods: A total of 834 patients aged 0–18 years who underwent anti-glaucoma surgery in Beijing Tongren Hospital from 2014 to 2019 were collected and their population characteristics and disease composition characteristics were retrospectively analyzed. Results: In all of the 834 cases, there were 397 patients (47.6%) with primary glaucoma and 429 (51.4%) with secondary glaucoma. The type of glaucoma could not be definitively diagnosed in 8 cases. Primary infant glaucoma and secondary glaucoma following cataract surgery accounted for above 50%. Conclusion: The causes of pediatric inpatients with glaucoma are various. Screening of primary infant glaucoma should be taken seriously and monitoring intraocular pressure after cataract surgery is also important. Early detection and treatment can prevent further visual loss of pediatric patients with glaucoma.
医学教育

以岗位需求为导向的培训模式在眼科手术室护士消毒供应专科培训中的应用

Application of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room

:384-388
 
目的:探讨以岗位需求为导向的培训模式在眼科手术室护士上岗前消毒供应专科专项培训中的应用效果。方法:手术室上岗前护士共44名,按随机分配原则,其中23名为实验组,另外21名为对照组。实验组以医院消毒供应中心三大行业标准和医院消毒技术规范为理论依据,以手术室护理岗位需求为目标,制定针对性培训内容,采用多方式培训方法,在消毒供应中心培训3个月考核合格后调入手术室。对照组直接调入手术室工作。采用手术室带教老师对新上岗护士满意度调查作为评价指标。结果:23名学员的理论知识考核、技术操作考核全部合格,小讲课顺利完成。手术室带教老师对实验组的满意度明显高于对照组。结论:建立以岗位需求为导向的眼科手术室护士消毒供应专科培训模式,有助于提高新上岗的手术室护士工作适应性,并提升手术室护士对专科器械的管理能力。
Objective: To explore the application effect of job demand-oriented training model in specialized training of sterile supplying for nurses in the ophthalmic operation room. Methods: A total of 44 nurses who would work in the operating room were randomly divided into the experimental group (n=23) and control group (n=21). Based on the three industrial standards of Central Sterile Supply Department (CSSD) and the technical specifications of disinfection in hospital, and targeting the job requirements of operating room nursing, the experimental group formulates specific training contents and adopts various training methods. The experimental group was transferred to the operating room after being trained in CSSD for 3 months and passing the examination. The control group was transferred directly to the operating room. The degree of satisfaction from the teachers of operating room to new nurses was used as the evaluation index. Results: All the 23 students passed the examination of theoretical knowledge and technical operation, and the small lectures were completed successfully. The degree of satisfaction from teachers in operating room to trainees was obviously higher than that of untrained nurses. Conclusion: The establishment of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room is helpful to improve the work adaptability of the newly-hired nurses in the operation room. It also helps the nurses in the operation room to enhance the management ability on the specialized instruments.
病例报告

儿童特发性眼眶炎性假瘤1例

Idiopathic orbital inflammatory pseudotumor in a child: A case report

:240-243
 
患儿因“左眼红肿12 d”就诊。左上睑红肿(++++),眼眶鼻侧可触及约黄豆大小硬结,界不清,质地中等,压痛(?),伴上睑下垂,遮盖角膜下缘。双眼眼位正,左眼眼球外转轻度受限。眼眶及视神经MRI显示左眼上睑软组织肿胀,考虑炎性改变。入院诊断为左眼特发性眼眶炎性假瘤(Idiopathic orbital inflammatory pseudotumor,IOIP)。予以激素治疗后症状好转且随访期间无复发。本例患儿为拒绝外院活检而就诊于暨南大学附属第一医院的小儿IOIP病例,提示早期规范治疗是降低此病复发率的关键,尤其是儿童患者。
The pediatric patient was referred to our hospital with a 12-day history of left eye redness and swelling. On the orbital and nasal side of the eye, there was a firm, nontender mass about the size of soybeans, with unclear boundary, medium texture. Orbital examination showed left ptosis, covering limbus. Motility examination revealed both eyes were in normal position, and the left eye was slightly limited in extraocular rotation. Magnetic resonance imaging (MRI) revealed evidence of diffuse inflammation of left eyelid, and orbital inflammatory was considered. Excluding other etiologies, the child was diagnosed initially with idiopathic orbital inflammatory. The symptoms improved after hormone therapy and there was no recurrence during follow-up. This case was a case of IOIP in a child who was admitted to the First Affiliated Hospital of Jinan University for refusing biopsy from another hospital. The paper suggests that early standardized treatment is the key to reduce the recurrence rate of this disease, especially in children.
综述

超广角眼底成像技术的发展及应用

Development and application of ultra-wide-field fundus imaging

:585-594
 
视网膜疾病大多以周边视网膜病变为首要表现,后者的早期诊断、监测对于视网膜疾病的治疗及预防起着至关重要的作用。以往传统眼底成像技术仅能提供20°视网膜的可视范围,即便使用蒙太奇拍摄技术,也只能采集部分眼底范围。目前眼底成像技术已步入最新的超广角时代,其所提供的眼底视野至少可达200°,并且基于该技术的超广角眼底彩色照相、荧光素血管造影、光学相干断层扫描及其血管造影等已广泛应用于临床实践中,对于诊断及评估视网膜疾病发挥重要作用,如糖尿病性视网膜病变、视网膜静脉阻塞、早产儿视网膜病变、视网膜色素变性及视网膜脱离等。本文将从超广角成像技术的产生、发展及其国内外的临床应用现状作一综述,旨在为临床工作及研究提供指导意义。
Retinal diseases primarily feature with peripheral retinopathy, and its early diagnosis as well as the later following up both play a vital role in the treatment and prevention of retinal diseases. In the past, traditional fundus imaging technology can only provide the visual range of 20 degrees. Even if montage photography technology is used, it can only partially reveal the fundus field. At present, fundus imaging technology has entered the latest era of ultra-wide-field, which provides at least 200-degree fundus field of vision. Ultra-wide-field fundus photochromy, fluorescein angiography, optical coherence tomography and angiography based on this technology have been widely used in clinical practice, and play an important role in the diagnosis and evaluation of retinal diseases, such as diabetes retinopathy, retinal vein occlusion, retinopathy of prematurity, retinitis pigmentosa and retinal detachment. This article aims to review the occurrence and development of ultra-wide-field fundus imaging technology and its clinical applications up to now to provide a relative guideline for clinic and research.
综述

不同类型人工晶状体的临床应用及研究进展

Clinical application and research progress of different types of intraocular lens

:577-584
 
    白内障作为一种常见的眼科疾病,是全球第一位致盲眼病,目前尚无药物能够治疗,手术是唯一有效的办法。随着现代眼科手术技术的发展以及人工晶状体(intraocular lens,IOL)设计和功能的更新升级,人们对视觉质量的要求越来越高,白内障超声乳化联合IOL植入术已经从单纯的复明手术转变为个性化的屈光手术。为满足不同需求的患者术后获得较好的视觉质量,IOL经历了从单焦点到多焦点、球面到非球面的发展,还有散光型IOL和各类功能性IOL的临床应用,也为患者提供了更多的选择。充分了解不同类型IOL的优势和特点,根据患者自身眼部情况、日常用眼习惯以及需求,个性化地选择IOL植入对视觉质量的恢复和满意度起着至关重要的作用。因此本文将针对不同类型的IOL,从设计与分类、术后临床效果及适应人群进行综述,为IOL的选择提供指导建议。
As a common eye disease, cataract is the first-leading cause of blindness in the world. Currently, there is no drug to treat it, and surgery is the only effective way. With the development of modern ophthalmic surgical technology and the updating and upgrading of the design and function of intraocular lens (IOL), people have higher and higher requirements for visual quality. Cataract phacoemulsification combined with IOL implantation has transformed from a simple vision restoration to personalized refractive surgery. In order to meet the needs of patients with different needs to obtain better visual quality after surgery, IOL has experienced the development from monofocal to multifocal, spherical to aspherical, as well as the clinical application of astigmatic IOL and various functional IOLs, which also provides more choices for patients. Fully understanding the advantages and characteristics of different types of IOLs, according to the patient’s own eye conditions, daily eye habits and needs, individualized selection of IOL implantation plays a crucial role in the recovery and satisfaction of visual quality. Therefore, this article will review different types of IOLs from the aspects of design and classification, postoperative clinical effects and adaptation to the population, and provide guidance for the selection of IOLs.
综述

泪液成分异常与不同泪膜破裂方式的研究进展

Research progress on abnormal tear composition and different break-up patterns of tear film

:571-576
 
    泪膜是覆盖于眼球表面的一层液体薄膜,从内而外分为黏液层、水液层和脂质层,每层成分的改变都会导致泪膜不稳定,进而导致干眼的发生。在研究泪膜破裂方式及相关泪液成分改变的基础上,学者Yokoi及其团队分别在2012年和2013年提出了有关干眼治疗和诊断的新概念,称为泪膜导向治疗(tear film-oriented therapy,TFOT)和泪膜导向诊断(tear film-oriented diagnosis,TFOD),就是根据泪膜破裂模式(tear film break-up pattern,TFBUP)的不同,推断出相应的泪膜成分改变,补充不足的泪膜成分,这种诊疗方法目前正逐渐被接受。本文对不同泪膜破裂方式与泪膜成分改变的关系做了汇总分析,旨在为干眼的诊断和治疗提供更为科学实用的指导方案。
    Tear film is a layer of fluid film covering the surface of eye global, which is divided into mucus layer, aqueous layer and lipid layer from inside to outside. The change of each layer composition will lead to tear film instability, resulting in the occurrence of dry eye. On the basis of numerous studies on the correlation between tear composition and tear film break-up patterns, Yokoi and his team proposed new concepts on the diagnosis and treatment of dry eye called tear film-oriented therapy (TFOT) and tear film-oriented diagnosis (TFOD) in 2012 and 2013. That is according to different tear film break-up patterns (TFBUP), so changes in tear film composition can be deduced and supplemented, and this diagnosis and treatment method is gradually being accepted. In this paper, we summarized and analyzed the relationship between different tear film break-up patterns and changes in tear film composition to provide a more scientific and convenient guidance program for the diagnosis and treatment of dry eye.

综述

FRMD7基因所致X连锁特发性先天性眼球震颤的研究进展

Research progress on X-linked idiopathic congenital nystagmus caused by FRMD7 gene

:563-570
 
特发性先天性眼球震颤(idiopathic congenital nystagmus,ICN)是一种常见的眼科疾病,患者常有明显的特征性的眼部异常,多伴有学习、社交障碍,对其身心健康影响较大。ICN遗传倾向明显,多表现为X染色体连锁(显性或隐性),目前研究发现以FRMD7基因突变致病较为显著。近10余年来,国内外学者们在遗传学方面针对ICN和FRMD7基因做了大量的研究工作,取得了令人瞩目的结果。本文就2006年以来研究者们在FRMD7基因所致X连锁ICN的突变类型及位点作一总结,归纳并探讨FRMD7突变可能的致病机制,旨在为学者们提供以往研究结果的查证和未来研究方向的参考。
Idiopathic congenital nystagmus (ICN) is a common ophthalmic disease in which patients often have obvious and characteristic eye abnormalities. ICN patients are often accompanied by learning and social disorders, have a great impact on their physical and mental health. ICN which has an obvious genetic tendency and is mostly manifested as X chromosome linkage (dominant or recessive). Current studies have found that the mutation of FRMD7 gene is the most significant pathogenic factor. In the past 10 years, researchers have done a lot of work on the genetics of ICN and FRMD7 gene, and achieved remarkable results. This review summarizes the typ mutations caused by FRMD7 gene since 2006, and also discusses the possible pathogenesis of FRMD7 mutations, aiming to provide references for scholars to verify previous research results and future research directions.
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
    浏览