目的：分析临床路径下青光眼住院费用变化情况，为制定合理的临床管理方法提供参考。方法：收集青光眼临床路径患者数据，建立 Excel 数据库，以 2016 年为基准对住院费用进行贴现计算后，应用 SPSS 软件对住院数据进行统计分析。结果：手术费用占总费用的比例最大，人均住院费用变化不明显，诊疗费逐年上升。随着日间手术的开展，实施临床路径管理的患者数量下降。结论：诊疗费用对提高医务人员工作积极性具有很重要的意义，随着日间手术的推广，将对临床路径的实施产生影响。

Objective: To investigate hospitalization costs through the inpatient costs of primary acute angle closure glaucoma between 2009 to 2016, and to provide a more suitable method for clinical management.

Methods: We collected the data of hospitalization patients with glaucoma from 2009 to 2016, coded and established the corresponding Excel databases. Based on a variety of statistics tables, descriptive analysis (according to SPSS for Windows 17.0) was applied to analyze the proportion of different types of hospitalization costs and simple linear regression was used to analyze the tendency of costs with years.
Results: Operation costs was the largest percentage of total cost; the average hospitalization cost change was not obvious, and the treatment costs rose year by year. With the development of day surgery, patients of clinical pathway management was decreased.
Conclusion: Increasing the medical expenses to improve medical staff’s work enthusiasm has very important significance. As day surgery, will affect the implementation of clinical pathway.

      原发性玻璃体视网膜淋巴瘤(primary vitreoretinal lymphoma, PVRL)作为原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma，PCNSL)的一个亚型，是一种罕见的致命性眼部恶性肿瘤。多数PVRL会伪装成慢性后葡萄膜炎，这使得临床诊断具有挑战性。玻璃体细胞、视网膜下液和影像学检查对临床诊断至关重要。而对恶性细胞的细胞学检查与组织病理学诊断是PVRL诊断的金标准。此外，免疫球蛋白重链(immunoglobulin heavy chain, IgH)或T细胞受体(Tcell receptor, TCR)基因重排的分子生物学检测、细胞标志物的免疫表型检测、以及细胞因子检测如IL-10的表达升高均可作为辅助诊断工具。目前PVRL的治疗主要包括局部放射及玻璃体腔内注射化疗药物(甲氨蝶呤和利妥昔单抗)，根据眼外组织是否受累决定是否联合全身化疗。对伴随PCNSL的患者，在全身大剂量甲氨蝶呤联合利妥昔单抗治疗的基础上，考虑联合局部治疗、全脑放疗和/或自体干细胞移植。尽管PVRL对初始治疗反应良好，但因其复发率高，常出现CNS受累，使PVRL的生存期预后较差。因此建立一个包含眼科医师、眼科病理学家、神经肿瘤学家以及血液肿瘤学家在内的专业团队来优化患者的治疗方案显得尤为重要。

      一名36岁的女性于16年前因静脉滴注“青霉素”引发Stevens-Johnson综合征，出现皮肤剥脱，口、鼻腔黏膜破损出血，双眼红肿伴分泌物增多等症状，当时经过治疗症状基本缓解。数月后开始反复出现眼部不适，2010年患者的视力明显下降，眼部疼痛加重，伴畏光流泪。至2016年入暨南大学附属第一医院时双眼最佳矫正视力仅0.1(右眼)、光感(左眼)，双眼角膜混浊，新生血管长入，甚至出现睑球粘连。80%的SJS患者可伴有眼部并发症，经过治疗症状缓解后，眼部病变仍可能继续进展，最终导致视力障碍甚至更严重的后遗症。因此患者病情稳定后仍须随诊，密切关注眼部、皮肤及黏膜的变化情况。

A 36-year-old woman developed Stevens-Johnson syndrome 16 years ago due to intravenous infusion of “penicillin”. She developed symptoms such as skin exfoliation, oral and nasal mucous damage, redness and swelling of the eyes, and increased secretions. TTe condition was relieved affer treatment. A few months later she repeated eye discomfort, in 2010 the patient’s visual acuity decreased significantly, eye pain increased with photophobia and tears. Her best-corrected visual acuity (BCVA) was only 0.1 for the right eye and light perception for the left eye, corneal opacity, angiogenesis, and even the symblepharon were observed when admitted to First Affiliated Hospital of Jinan University in 2016. About 80% of Stevens-Johnson syndrome patients may be accompanied by ocular complications. Although the ocular symptoms are relieved after treatment, eye disease is still likely to progress, eventually leading to visual impairment and even more serious sequelae. TTerefore, patients with stable condition still need follow-up, and close attention should be paid to the changes of the eyes, skin and mucous membranes.

目的：探讨飞秒激光辅助角膜内皮移植(endothelial keratoplasty，EK)患者的护理。方法：对40例 行飞秒激光辅助EK术的患者做好术前心理护理，完善术前检查及术前准备，术后重点做好体位护 理、病情观察及出院指导。结果：4例患者术后发生植片移位，经再次复位后贴合良好，1例术后第1天气泡到后房行前房成形术；13例患者术后出现眼压升高，经治疗眼压得到控制；40例患者全 部治愈出院。结论：对EK术患者应做好术前及术后的护理，及时发现并发症并采取相应的治疗与护理措施，以提高手术的成功率。

Objective: To explore the nursing care of patients with femtosecond laser assisted endothelial transplantation. Methods: Forty patients were involved in this study. Preoperative psychological nursing, ocular examination, and surgical preparation were taken, and the main nursing postoperation focused on patients’ position and the discharge guidance. Results: TTe graffs in 4 cases were displaced, and were all in place affer resetting. The bubble was observed in posterior chamber in 1 case, this case was taken anterior chamber forming operation. Intraocular pressure was high in 13 cases, and those cases were treated with topical medicines. Conclusion: Completing the preoperative nursing of patients with corneal endothelial transplantation, observing the complications and taking corresponding treatment and nursing measures help improve the success rate of the operation.  

目的：探讨延伸护理对角膜移植术后的作用及临床意义。方法：回访收集 71 例角膜移植术后患者院外用药、视力及门诊随访病情信息，将患者随机分为延伸护理组与常规护理组，延伸护理组 36 例，常规护理组 35 例，比较两组术前后视力变化值、家庭功能与生活质量评分及遵医行为。结果：延伸护理组与常规护理组在手术前后视力均明显改善，而两组组间差异无统计学意义（P > 0.05）。延伸护理前后家庭功能与生活质量评分差异有统计学意义（P < 0.05），而常规护理前后评分无差异（P > 0.05），两组间比较差异有统计学意义（P < 0.05）。延伸护理在遵医嘱行为方面显著优于常规对照组（P < 0.05）。结论：延伸护理能明显改善角膜移植术后患者治疗与护理依从性，能良好体现护理专业价值与社会服务功能，有助于患者从医院到居家的平稳过渡。

Objective: To investigate the effect of extended nursing care on corneal transplantation and its clinical significance. Methods: Clinical data of 71 patients after corneal transplantation, including extramural medication, visual acuity and outpatient follow-up were collected. The patients were randomly divided into the extended nursing care (n = 36) and routine nursing care groups (n = 35). The changes of visual acuity, family function and quality of life were compared between two groups. Results: The visual acuity in two groups was significantly improved after surgery, but no significant difference was noted between two groups (P > 0.05). The family function and quality of life scores significantly differed before and after extended care (P < 0.05), and there was no difference in the score before and after routine care (P > 0.05), there was a significant difference between the two groups (P < 0.05).Extended care was significantly superior to the routine care (P < 0.05). Conclusion: Extended nursing care can obviously improve the compliance of treatment and nursing of patients after corneal transplantation. It can reflect the value of nursing profession and social service function, and help patients to make a smooth transition from hospital to home.

目的：研究佛山市南海区第四人民医院（以下简称 “我院”）五官科 2016 年白内障入院治疗的患者临床资料。方法：回顾性分析 2016 年间在我院五官科的住院患者，以 “白内障” 为检索词查阅病历管理系统，导出 Excel 文件，查阅相关病例资料进行统计分析。结果：2016 年共收治白内障患者 132 例 145 眼，其中男 56 例 59 眼，女 76 例 86 眼，年龄（72.98±6.89）岁。年龄相关性白内障占91.72%。其中 136 例接受白内障手术治疗。手术患者术前最佳矫正视力1.31±0.41，术后最佳矫正视力0.20±0.16，各月份入院患者人数平均。核性白内障患者入院年龄与皮质型及后囊下型患者有统计学差异，但3种类型的术前及术后视力无统计学差异。结论：我院白内障患者入院临床分布年龄多集中于 70~79 岁，女性患者，皮质型及后囊下型年龄相关性白内障患者选择手术时间早于核性年龄相关性白内障。

Objective: To study the clinical data of cataract patients admitted to the Fourth People’s Hospital of Nanhai Destrict of Foshan City in 2016. Methods: We retrospectively analyzed the inpatients in the Department of Eye & ENT of the hospital. We consulted the medical record management system with the term “cataract” and the results were derived to Excel files for statistical analysis. Results: A total of 132 cases (145 eyes) of cataract were hospitalized in 2016, including 56 male cases (59 eyes) and 76 female cases (86 eyes). The age was (72.98±6.89) years old. Among them, the percentage of age-related cataract was 93.72%; 136 cases were treated with cataract surgery. The preoperative best corrected visual acuity was 1.31±0.41, and the postoperative best corrected visualacuity was 0.20±0.16. The number of patients admitted to hospital was almost equivalent in each month. The admission age of nuclear cataract patients was significantly different from that of those with cortical type and posterior subcapsular type cataract, but there was no significant difference in preoperative and postoperative visual acuity among the three types of age-related cataract. Conclusion: The cataract patients in our hospital are mainly aged 70–79 years old, primarily in female patients. The operation time for patients with cortical and posterior subcapsular age-related cataract is earlier compared with that for those with nuclear age-related cataract.

目的：探索新形势下建立医院多院区一体化运维管理系统。方法：运用 SWOT 分析法全面分析医院信息、后勤和设备三大部门运维管理状况，进而对运维一体化模式进行全面剖析。结果：医院多院区一体化运维发展战略在信息运维一体化系统建设工作实践中取得显著成效，提升了工作效率和医院核心竞争力。结论：SWOT 分析法对医院多院区一体化发展战略研究提供了理论基础，为医院多院区一体化管理提供了扎实有效的理论参考。

Objective: To establish the new eye hospital operational integration management mode. Methods: Using SWOT to analysis of hospital information management operations, logistics and equipment department, comprehensive analysis of operational integration mode. Results: We proposed hospital campus more operational integration development strategy, and in the practice of the information integration of operational work achieved remarkable achievement, which improved the working efficiency and the hospital core competitiveness. Conclusion: The SWOT analysis method for hospital operational integration development strategy research, provides a theoretical basis for hospital campus more leapfrog development provides a solid and effective theoretical reference.

目的：探讨视网膜激光光凝发生眼心反射的发生情况及护理。方法：选择佛山市第二人民医院 2015 年 1 月至 2018 年 6 月行视网膜激光光凝患者 5 600 例，记录眼心反射发生率、临床特点、血压脉搏变化及现场抢救、护理情况。结果：所有视网膜激光光凝患者中，21 例出现眼心反射症状，发生率为 0.38％，年龄（32.5±14.8）岁，其中 42.9％ 为 18～25 岁年轻女性，90.5％ 为视网膜变性裂孔，66.7％ 为视网膜颞下方病变。眼心反射发生时平均收缩压（76.7±11.3）mmHg，舒张压（52.9±10.5）mmHg，脉搏（58.0±7.3）min^-1。患者均自行缓解，未出现心搏骤停及紧急抢救情况。结论：视网膜激光光凝中有眼心反射发生的风险，尤其是年轻女性或颞下方视网膜变性裂孔患者，应当重点关注和加强心理护理，并作好急救准备。

Objective: To explore the clinical characteristics and nursing measures in patients with oculocardiac reflex during retinal laser therapy. Methods: A total of 5 600 patients during retinal laser therapy during January 2015 to June 2018 were included. Incidence of oculocardiac reflex, clinical characteristics, changes in blood pressure and pulse, and nursing measures were recorded in this study. Results: Among 5 600 patients during retinal laser therapy, 21 cases (0.38%), aged (32.5±14.8) years old on average, presented with oculocardiac reflex, including 42.9% of them were young female patients aged 18–25 years; 90.5% of patients with oculocardiac reflex suffered from retinosis or retinal tear, and 66.7% of the retinal lesions were located in the inferotemporal region. The mean systolic pressure was (76.7±11.3) mmHg when oculocardiac reflex occurred, and the mean diastolic pressure was (52.9±10.5) mmHg, and the mean pulse was (58.0±7.3) min^-1. The symptoms of oculocardiacreflex in all patients spontaneously restored with time. No patient had cardiac arrest or needed emergency rescue. Conclusion: Oculocardiac reflex may occur in patients during retinal photocoagulation, especially in young female patients or those presenting with inferotemporal retinosis or retinal tear. More attention and psychological nursing care should be paid before laser and the emergency rescue should be prepared.

目的：探讨多点电凝视网膜切开术治疗眼外伤复发性视网膜脱离的护理。方法：回顾总结眼外伤复发性视网膜脱离患者行多点电凝视网膜切开术的围手术期护理。结果：9 例患者中 7 例获得视网膜复位，视网膜再次复位率达到 78％，围手术期无明显并发症。结论：做好术前的心理护理及健康指导，术中配合及术后的体位护理，病情观察，出院后随访等护理措施对巩固手术效果，促进康复起重要作用。

Objective: To explore the key procedures of perioperative nursing care for recurrent retinal detachment in patients with ocular trauma by using radial retinotomies. Methods: Perioperative nursing care data of 9 ocular trauma patients who underwent radial retinotomies in Zhongshan Ophthalmic Center from 2014 to 2016 were retrospectively analyzed. Results: Among 9 patients, 7 cases achieved retinal reattachment with a success rate of 78%. No significant complications were observed during the perioperative period. Conclusion: Preoperative psychological nursing and health guidance, intraoperative cooperation, correct body position for postoperative nursing, monitoring of physical conditions and postoperative follow-up can enhance the surgical efficacy and accelerate postoperative recovery.

甲状腺相关眼病是最常见的眼眶疾病，公认是一种自身免疫性疾病，因眶内免疫及增殖反应而致突眼、压迫性视神经病变等各种临床表现。近年眼科、内分泌科、核医学科、放疗科针对该疾病开展了一系列的临床研究，制定了相应的临床处理指南。研究显示，被转诊到三级中心的甲状腺相关眼病患者的严重度和活动性有下降的趋势，这可能与对该疾病认识的增强、甲亢和甲状腺相关眼病的早期诊断和治疗以及更有效地使用预防措施有关。但国内临床工作中碰到严重的甲状腺相关眼病患者反有增加的趋势，这可能与临床对该疾病的重视和规范化诊治程度不够有关。

Thyroid-associated ophthalmopathy is the most common orbital disease. It is recognized as an autoimmune disease, which causes exophthalmos, oppressive optic neuropathy and other clinical manifestations due to infraorbital immunity and proliferation reaction. In recent years, ophthalmologists, endocrinologists, nuclear medicine doctors and radiotherapists have carried out a series of clinical studies on the disease and formulated corresponding clinical treatment guidelines. Overseas reports indicate that the severity and activity of thyroidassociated ophthalmopathy patients referred to tertiary centers are declining, which may be related to increased awareness of the disease, early diagnosis and treatment of hyperthyroidism and thyroid-associated ophthalmopathy, and more effective use of preventive measures. However, the number of patients with severe thyroid-associated ophthalmopathy is increasing in our clinical work, which may be related to our lack of attention to the disease and standardized diagnosis and treatment.