目的探讨可吸收泪点栓治疗准分子激光原位角膜磨镶术（LASIK）前伴干眼症患者的效果。方法前瞻性随机双肓对照研究。选取行LASIK术治疗，术前伴轻、中度干眼症的患者41例，同一患者的两眼随机分组，一眼采用可吸收泪点栓结合药物治疗（...目的探讨可吸收泪点栓治疗准分子激光原位角膜磨镶术（LASIK）前伴干眼症患者的效果。方法前瞻性随机双肓对照研究。选取行LASIK术治疗，术前伴轻、中度干眼症的患者41例，同一患者的两眼随机分组，一眼采用可吸收泪点栓结合药物治疗（试验组），另一眼采用单纯药物治疗（对照组）。记录泪点栓的并发症，比较两眼LASIK术前，术后1周和1、3、6个月时泪液分泌试验（SIT）、角膜荧光素染色（FL）、泪膜破裂时间（BUT）和眼表疾病评分（OSDI）的值。运用两相关样本的非参数检验方法（Two Related SamplesTest）进行数据分析。结果除1例患者术后第1天泪点栓脱落外，未见其他并发症。术后1周，试验组的SIT值高于对照组，差异有统计学意义（Z=-2．005，P=0．045），术后1个月及以后，两组的SIT值趋于一致。术后1周、1个月和3个月，试验组的FL值均低于对照组，差异有统计学意义（Z=-2．124、-2．009、-2．120，P〈0．05）。而两组的OSDI和BUT值在上述各时间点差异均没有统计学意义。结论可吸收泪点栓是治疗LASIK术前伴干眼症患者的安全有效的方法。展开更多
目的探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后植入可吸收泪点栓对泪膜功能的影响。设计前瞻性病例系列。研究对象2012年3-7月北京同仁医院行LASIK手术有轻度干眼的近视眼患者30例60眼。方法患者双眼一眼...目的探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后植入可吸收泪点栓对泪膜功能的影响。设计前瞻性病例系列。研究对象2012年3-7月北京同仁医院行LASIK手术有轻度干眼的近视眼患者30例60眼。方法患者双眼一眼植入可降解VisiPlug泪点栓(30眼),另一眼不植入泪点栓作为对照(30眼)。术前、术后第7天进行Schirmer I试验(SIt)、泪膜破裂时间(TBUT)、角膜荧光素染色、前节相干光断层扫描(OCT)泪河情况检查。主要指标SIt,TBUT,角膜荧光素染色程度,泪河面积、高度和深度。结果术后第7天泪点栓植入组与对照组的SIt分别是(9.7±1.18)、(8.3±1.35)mm(t=-0.53,P=0.052);TBUT分别是(6.63±0.34)、(6.53±0.40)秒(t=0.209,P=0.836);泪河面积分别是(0.020±0.002)、0.020±0.002)mm2(t=-0.106,P=0.916);泪河高度分别是(207.40±8.59)、(215.40±11.10)μm(t=-0.777,P=0.444);泪河深度分别是(177.77±7.10)、(180.60±7.00)μm(t=-0.377,P=0.709);角膜荧光素染色分级中位数分别是(0,0)级(Z=0.707,P=-0.480)。泪点栓植入组术后与术前比较,SI(t9.7±1.18 mm,7.17±1.03 mm)、TBUT(8.3±1.35秒,7.9±1.25秒)显著增加(P均<0.05);而泪河面积、高度、深度,角膜荧光染色分级均无显著性差异。对照组术后与术前比较,各项指标均无显著性差异。结论本研究在有限随访时间内结果显示对于轻度干眼者,LASIK术后没有必要植入可吸收泪点栓预防干眼。展开更多
Objective: To investigate pathological changes in surgically excised specimens from resectable large hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE ) and their ...Objective: To investigate pathological changes in surgically excised specimens from resectable large hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE ) and their signi?cance. Methods: From January 2002 to January 2003, 83 patients with resectable large HCC were randomized into two groups: group A, 36 patients who underwent preoperative TACE, and group B, 47 patients who underwent one-stage operation without TACE. Hepatectomy was performed in 31 patients of group A (two-stage operation group) and 47 patients of group B (one-stage operation group). The remaining 5 patients in group A were not operable. The diagnosis of HCC was pathologically con?rmed in all 78 patients after hepatectomy. Pathological changes of the excised specimens between the two groups were compared, including main tumors, capsular containment, daughter nodules, tumor thrombi and liver cirrhosis. Results: There were no signi?cant di?erences in the incidence of daughter nodules , portal vein tumor thrombi (PVTT) and extrahepatic metastasis between the two groups, but the area of main tumor necrosis was more extensive and the rate of encapsulation was higher in two-stage operation group than those in one-stage operation group. No signi?cant shrinkage in the average tumor size was seen in two- stage operation group, where daughter nodules and PVTT necrosis were less, and liver cirrhosis was more serious. Conclusion: Preoperative TACE for resectable large HCC should be used on the basis of strict selection because it does not provide complete tumor necrosis and may result in delayed surgery in some cases.展开更多
Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE). Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, res...Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE). Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy. Results: Two of the nine patients died of severe complications, the other seven recovered without severe sequela. Conclusions: Gurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.展开更多
文摘目的探讨可吸收泪点栓治疗准分子激光原位角膜磨镶术（LASIK）前伴干眼症患者的效果。方法前瞻性随机双肓对照研究。选取行LASIK术治疗，术前伴轻、中度干眼症的患者41例，同一患者的两眼随机分组，一眼采用可吸收泪点栓结合药物治疗（试验组），另一眼采用单纯药物治疗（对照组）。记录泪点栓的并发症，比较两眼LASIK术前，术后1周和1、3、6个月时泪液分泌试验（SIT）、角膜荧光素染色（FL）、泪膜破裂时间（BUT）和眼表疾病评分（OSDI）的值。运用两相关样本的非参数检验方法（Two Related SamplesTest）进行数据分析。结果除1例患者术后第1天泪点栓脱落外，未见其他并发症。术后1周，试验组的SIT值高于对照组，差异有统计学意义（Z=-2．005，P=0．045），术后1个月及以后，两组的SIT值趋于一致。术后1周、1个月和3个月，试验组的FL值均低于对照组，差异有统计学意义（Z=-2．124、-2．009、-2．120，P〈0．05）。而两组的OSDI和BUT值在上述各时间点差异均没有统计学意义。结论可吸收泪点栓是治疗LASIK术前伴干眼症患者的安全有效的方法。
文摘Objective: To investigate pathological changes in surgically excised specimens from resectable large hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE ) and their signi?cance. Methods: From January 2002 to January 2003, 83 patients with resectable large HCC were randomized into two groups: group A, 36 patients who underwent preoperative TACE, and group B, 47 patients who underwent one-stage operation without TACE. Hepatectomy was performed in 31 patients of group A (two-stage operation group) and 47 patients of group B (one-stage operation group). The remaining 5 patients in group A were not operable. The diagnosis of HCC was pathologically con?rmed in all 78 patients after hepatectomy. Pathological changes of the excised specimens between the two groups were compared, including main tumors, capsular containment, daughter nodules, tumor thrombi and liver cirrhosis. Results: There were no signi?cant di?erences in the incidence of daughter nodules , portal vein tumor thrombi (PVTT) and extrahepatic metastasis between the two groups, but the area of main tumor necrosis was more extensive and the rate of encapsulation was higher in two-stage operation group than those in one-stage operation group. No signi?cant shrinkage in the average tumor size was seen in two- stage operation group, where daughter nodules and PVTT necrosis were less, and liver cirrhosis was more serious. Conclusion: Preoperative TACE for resectable large HCC should be used on the basis of strict selection because it does not provide complete tumor necrosis and may result in delayed surgery in some cases.
文摘Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE). Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy. Results: Two of the nine patients died of severe complications, the other seven recovered without severe sequela. Conclusions: Gurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.
