玻璃体黄斑界面疾病主要包括玻璃体黄斑牵引综合征、特发性黄斑视网膜前膜和特发性黄斑裂孔。光学相干断层扫描(optical coherence tom ography,OCT)作为一种新的能提供高分辨活体组织横截面图像的非损伤性影像学检查技术,具有独特的高...玻璃体黄斑界面疾病主要包括玻璃体黄斑牵引综合征、特发性黄斑视网膜前膜和特发性黄斑裂孔。光学相干断层扫描(optical coherence tom ography,OCT)作为一种新的能提供高分辨活体组织横截面图像的非损伤性影像学检查技术,具有独特的高分辨率、无损伤性等特点,自临床广泛应用以来,为临床玻璃体黄斑界面疾病的诊断、鉴别诊断、病情的监测以及定量评估、治疗方案的选择等方面提供了重要信息及参考价值。我们对玻璃体黄斑界面疾病在OCT图像中的解剖形态学特征的了解,促进了临床对疾病发生、发展的认识。下面我们就OCT在玻璃体黄斑界面疾病的应用进展加以综述。展开更多
Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitut...Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitute for droperidol,because the Food and Dru g Administration has required a Black Box warning on th e droperidol package insert.Design Randomized,placebo-controlled,double-blinded trial.Participant s Inpatients undergoing vitreoretinal surgery(standard 3-port pars plana vitrecto-my for proliferative diabetic vitre oretinopathy,complicat-ed retinal detachment,or macular di sease,such as macular pucker,macular hole,or choroidal neovascu-larization).Intervention Two hundred forty patients(3×80)receiving droperidol(10μg·kg -1 ),dolasetron(12.5mg ),or the combination of both drugs adm inis-tered 5to 10minutes before the end of surgery.Control Eighty patients received saline pla cebos as controls.Methods Standardized general anesthesia was performed,including benzodiazepine premedic ation,propofol,a-tracurium or vecuronium,desfluran e in N 2 O /O 2 ,and a continuous infusion of remifentani l.Postoperative anal-gesia and antiemetic rescue medication were standard-ized.Episodes of vomiting,retchin g,nausea,and the need for additional antiemetics were recorded for 24hours.Main outcome measures Severity of PONV(rated by a standardized scoring algorithm)-was analyzed as the main end point of the study using the K ruskal-Wallis test.Results Data of 304patients could be analyzed.Mean severity scores in the placebo,dolasetron,droperidol,and combination groups were 1.21,0.76,0.47,and 0.30.Incidences of PONV of any severity were 56%,40%,28%,and 18%,respectively.The reduction of the incidence of PONV an d its severity was statistically significant in the dr operidol group and in the combination group relative to the pl acebo.Dolasetron alone failed to reduce the incidence of PONV.The combination of dolasetron and droperidol showed an ad-ditive antiemetic efficacy.Conclu sion Low-dose droperi-dol(10μg·kg -1 )but not dolasetron(12.5mg )re-duced postoperative nausea and vomi ting after vitreoreti-nal surgery.Dolasetron(12.5mg )is not an equivalent substitute for droperidol.展开更多
文摘目的：观察微创23G 玻璃体切割手术联合内界膜剥除术治疗玻璃体黄斑交界面疾病的临床疗效。方法回顾分析2015年1月至2015年6月在首都医科大学附属北京友谊医院眼科诊断为玻璃体视网膜界面疾病并接受了23G 微创玻璃体切割联合内界膜剥除术的26眼病例，术后随访3-6个月。使用频域相干光断层扫描（SD - OCT）观察术后黄斑形态变化恢复情况，并比较术前术后视力。结果术后 SD - OCT 提示玻璃体牵拉、黄斑前膜消失，黄斑水肿较术前减轻。11眼黄斑裂孔闭合，仅1眼未完全闭合。患者术前最佳矫正视力0.19±0.12，术后最后随访最佳矫正视力0.28±0.13。两者进行配对 t 检验，差异具有统计学意义（ t =-6.153，P =0.000）。所有患者术中术后未发生严重并发症。结论对于玻璃体黄斑交界面疾病的患者，采用微创23G 玻璃体切割联合内界膜剥除术安全、有效，能明显改善术眼视力。
文摘玻璃体黄斑界面疾病主要包括玻璃体黄斑牵引综合征、特发性黄斑视网膜前膜和特发性黄斑裂孔。光学相干断层扫描(optical coherence tom ography,OCT)作为一种新的能提供高分辨活体组织横截面图像的非损伤性影像学检查技术,具有独特的高分辨率、无损伤性等特点,自临床广泛应用以来,为临床玻璃体黄斑界面疾病的诊断、鉴别诊断、病情的监测以及定量评估、治疗方案的选择等方面提供了重要信息及参考价值。我们对玻璃体黄斑界面疾病在OCT图像中的解剖形态学特征的了解,促进了临床对疾病发生、发展的认识。下面我们就OCT在玻璃体黄斑界面疾病的应用进展加以综述。
文摘Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitute for droperidol,because the Food and Dru g Administration has required a Black Box warning on th e droperidol package insert.Design Randomized,placebo-controlled,double-blinded trial.Participant s Inpatients undergoing vitreoretinal surgery(standard 3-port pars plana vitrecto-my for proliferative diabetic vitre oretinopathy,complicat-ed retinal detachment,or macular di sease,such as macular pucker,macular hole,or choroidal neovascu-larization).Intervention Two hundred forty patients(3×80)receiving droperidol(10μg·kg -1 ),dolasetron(12.5mg ),or the combination of both drugs adm inis-tered 5to 10minutes before the end of surgery.Control Eighty patients received saline pla cebos as controls.Methods Standardized general anesthesia was performed,including benzodiazepine premedic ation,propofol,a-tracurium or vecuronium,desfluran e in N 2 O /O 2 ,and a continuous infusion of remifentani l.Postoperative anal-gesia and antiemetic rescue medication were standard-ized.Episodes of vomiting,retchin g,nausea,and the need for additional antiemetics were recorded for 24hours.Main outcome measures Severity of PONV(rated by a standardized scoring algorithm)-was analyzed as the main end point of the study using the K ruskal-Wallis test.Results Data of 304patients could be analyzed.Mean severity scores in the placebo,dolasetron,droperidol,and combination groups were 1.21,0.76,0.47,and 0.30.Incidences of PONV of any severity were 56%,40%,28%,and 18%,respectively.The reduction of the incidence of PONV an d its severity was statistically significant in the dr operidol group and in the combination group relative to the pl acebo.Dolasetron alone failed to reduce the incidence of PONV.The combination of dolasetron and droperidol showed an ad-ditive antiemetic efficacy.Conclu sion Low-dose droperi-dol(10μg·kg -1 )but not dolasetron(12.5mg )re-duced postoperative nausea and vomi ting after vitreoreti-nal surgery.Dolasetron(12.5mg )is not an equivalent substitute for droperidol.
