荧光素眼底血管造影（fundus fluorescein angiography, FFA）是眼底疾病诊疗不可或缺的检查技术。虽然开展已有半个世纪，但临床工作者在FFA操作的规范性、科学性、安全性和结果同质性仍有不少顾虑和问题，同时缺乏相关指南和共识可供参考。中国微循环学会眼微循环专业委员会眼影像学组专家就FFA操作规范达成本共识，就开展FFA的条件和配置、适应证和禁忌证、检查前准备、检查操作程序、不良反应及处理、造影后患者告知和处理、造影报告等方面为FFA临床操作工作者提供建议和指导，以期在临床实践中获取良好眼底影像、减少不良反应、提高检查质量效率。
Fundus fluorescein angiography (FFA) is an indispensable examination for the diagnosis and treatment of ocular fundus diseases. Although FFA has been carried out for half a century, clinicians still have many concerns and problems in the standardization, scientificity, safety and result homogeneity of FFA practice, and there is a lack of relevant guidelines and consensus for reference. The experts of the Ophthalmic Imaging Group of the Ocular Microcirculation Division of the Chinese Society of Microcirculation reached a consensus on the standardized practice of FFA, providing suggestions and guidance for FFA operators about the clinical conditions and configurations, indications and contraindications, pre-examination preparation, examination procedures, adverse reactions and treatment, patient notification, and angiography reports, in order to obtain good fundus images, reduce adverse reactions, and improve the quality and efficiency of FFA examinations in clinical practice.
Background: To explore the difference between the outcomes of correlations between a series of variables and adverse reactions (ARs) to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.Methods: A retrospective study of patients undergoing consecutive fluorescein angiography between March 2010 and February 2012 was conducted. No patients were excluded on the ground of age, presence of atopy, allergy history, previous procedures without severe allergic ARs, asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250 μmol/L or with renal dialysis.Results: A total of 829 patients were enrolled and 22.2% of them had ARs. The majority of reactions were nausea (12.1%) which occurred less when age became old (P<0.0001). When the correlations between a series of variables and ARs were assessed separately, age (P<0.0001), prior reactions (P<0.0001) and motion sickness (P=0.0062) were highly and cardio/cerebrovascular disease (P=0.0015), diabetes (P=0.0001) and renal disease (P=0.0219) were lowly related to ARs. However, when the correlations were assessed simultaneously, only age [odd ratio (OR) 0.974; 95% confidence interval (CI), 0.962–0.986], prior reactions (OR 5.596; 95% CI, 2.083–15.029) and motion sickness (OR 4.849; 95% CI, 1.583–14.856) were statistically correlated with ARs.Conclusions: Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease. Young age, prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.
Background: To explore the difference between the outcomes of correlations between a series of variables and adverse reactions (ARs) to fluorescein from univariate and multivariate analysis and to evaluate the nausea effects in different age groups.Methods: A retrospective study of patients undergoing consecutive fluorescein angiography between March 2010 and February 2012 was conducted. No patients were excluded on the ground of age, presence of atopy, allergy history, previous procedures without severe allergic ARs, asymptomatic hypertension and kidney failure with serum creatinine levels lower than 250 μmol/L or with renal dialysis.Results: A total of 829 patients were enrolled and 22.2% of them had ARs. The majority of reactions were nausea (12.1%) which occurred less when age became old (P<0.0001). When the correlations between a series of variables and ARs were assessed separately, age (P<0.0001), prior reactions (P<0.0001) and motion sickness (P=0.0062) were highly and cardio/cerebrovascular disease (P=0.0015), diabetes (P=0.0001) and renal disease (P=0.0219) were lowly related to ARs. However, when the correlations were assessed simultaneously, only age [odd ratio (OR) 0.974; 95% confidence interval (CI), 0.962–0.986], prior reactions (OR 5.596; 95% CI, 2.083–15.029) and motion sickness (OR 4.849; 95% CI, 1.583–14.856) were statistically correlated with ARs.Conclusions: Fluorescein angiography is a safe procedure for patients who are relatively healthy but with a history of any systemic disease. Young age, prior reactions and motion sickness which are highly related to emetic events should be considered in the evaluation of ARs to fluorescein.
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
目的：观察喉罩通气吸入七氟醚麻醉在小儿眼底荧光素造影检查(fundus fluorescein angiography，FFA)期间眼位情况、眼球运动的发生率和丙泊酚调整眼位的有效率。方法：回顾性分析2018年6月至2019年12月七氟醚麻醉下接受FFA的儿童的病例资料，记录检查开始时眼位分级、检查中眼球运动发生率、丙泊酚调整眼位的有效率、麻醉后恢复自主活动时间以及不良事件。结果：纳入1~9岁患儿54例，检查开始时42.6%(23/54)的患者眼位1级，51.9%(28/54)的患者眼位2级，5.6%(3/54)的患者眼位3级，检查中眼球运动发生率为61.1%(33/54)。13%(7/54)的患儿需丙泊酚干预，丙泊酚1 mg/kg纠正眼位的有效率为100%。患儿麻醉后恢复正常活动的平均时间为24.4 min，未发生不良事件。结论：喉罩复合七氟醚的麻醉可为门诊小儿眼底荧光造影提供相对满意的麻醉质量，患者在麻醉后可迅速恢复日常活动，丙泊酚可迅速纠正检查中眼位不正。
Objective: To observe the eye position, the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography (FFA) with inhaled sevoflurane via laryngeal mask airway. Methods: Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed. Eye position at the beginning of examination, incidence of eye movement during examination, the efficiency of propofol on correcting eccentric eyeball position during procedure, the time to resume normal activities, and adverse events were recorded. Results: Fifty-four children aged 1–9 years were included in this study. The rates of eye position from grade one to grade three at the beginning of examination were 42.6% (23/54), 51.9% (28/54), and 5.6% (3/54), respectively. The incidence of eye movement during examination was 61.1% (33/54). 13% (7/54) of children with unsatisfactory eye-position needed intervention with propofol. The efficacy of propofol (1 mg/kg) in correcting eye position was 100%. The mean time to return normal activities was 24.4 min. There were no any adverse events during the peri-anesthetic period. Conclusion: Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children. Children can resume daily activities soon after anesthesia. Propofol can return the incorrect eye position during examination
