Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
目的探讨毒品注射致假性动脉瘤急性破裂大出血后的急救处理。方法回顾性分析12例毒品注射致假性动脉瘤急性破裂出血患者的临床资料。结果均行单纯清创和血管修补术，术后1例患者诉右足轻度麻木，出院2个月后消失，无跛行。其余11例患者术后至出院无明显缺血表现。结论对毒品注射所致假性动脉瘤急性破裂大出血患者行单纯清创和血管修补术，手术操作简便，术后患肢血供恢复好，且费用低，适合在广大基层医院开展。
Several unusual manifestations such as white bile draining in common bile duct (14 cases) and casual massive bleeding (2 cases ) during and following hepatobiliary and pancreatic operations is reported. These manifestations were in fact signs of hepatic insufficiency. The manners of manifestations of hepatic insufficiency and their treatment are discussed, with a stress that liver-protective treatment and nutritional support are the fundamental modalities.
目的：评价低分子肝素(Low molecular weight heparins，LMWH)皮下注射持续时间对注射后皮下出血和疼痛的影响。方法：纳入2003年～2004年3月于我院行LMWH皮下注射的住院患者52例，以肚脐两侧作为注射点，任选一侧行首次注射，12 h后于另一侧以相同剂量注射。脐右注射持续10秒(对照组)，脐左持续30秒(实验组)。于注射后48 h、72 h观察注射点有无皮下出血，并用透明纸质毫米尺测量出血面积，用视觉类比量表(Visual analog scale，VAS)测量疼痛强度，记录疼痛持续时间。采用卡方检验及配对t检验对两组皮下出血发生率及面积、疼痛强度及持续时间等指标进行对比分析。结果：实验组和对照组皮下出血的发生率分别为38.5%(n=20)和61.5%(n=32)(P=0.035)。注射后48h、72h，实验组的出血面积均显著低于对照组(48h：17.5±7.3 mm2 VS 101.2±15.0 mm2，P=0.008；72h：20.7±8.0 mm2 VS 110.4±13.5 mm2，P=0.016)。实验组的注射后疼痛积分为13.0±6.4 mm，对照组为21.5±7.0 mm(P=0.021)。实验组疼痛持续时间显著低于对照组(42.5±14.2 s比73.2±20.0 s，P=0.030)。结论：肝素皮下注射持续时间能显著影响注射后皮下出血和疼痛形成，注射时间持续至30秒能有效降低皮下出血发生率及面积，并显著减轻疼痛强度、缩短疼痛时间。
Objective To apply the method of evidence-based medicine to identify the best therapy option for an emergency patient with upper gastrointestinal hemorrhage. Methods According to time and logical sequence of clinical events, a complete decision tree was built after the following steps to find the best treatment: clear decision-making, drawing decision tree graphics, listing the outcome probability, giving appropriate values to the final outcome, calculating and determining the best strategies. Results The performance of endoscopic therapy for the patient with upper gastrointestinal hemorrhage within the first six hours had little effect on the prognosis. Interventional therapy after the failure of endoscopic therapy had less mortality than direct surgical exploration. Conclusion Making clinical decision analyses via drawing the decision tree can help doctors clarify their ideas, get comprehensive views of clinical problems, and ultimately choose the best treatment strategy for patients.
Objective To evaluate the effective method for treatment of premacular hemorrhage. Methods In 36 cases (36 eyes) of premacular hemorrhage (2PD),25 cases were treated with medicine, and 11 cases were treated with laser surgery and medicine. Results In 25 patients treated with medicine, the average time of vision recovery was 24 days and the average time of clearance of vitreous hemorrhage was 40 days; in the other 11 patients treated with laser surgery and medicine,10 were treated successfully, and in these 10 patients, the average time of vision recovery were 5 days and the average time of clearance of premacular hemorrhage were 11 days in 10 cases which were operated successfully with laser in 11 cases. Conclusions Laser surgery of inducing preretinal hemorrhage to vitreous body is an effective method for treatment of premacular hemorrhage to relieve the impaired central vision. (Chin J Ocul Fundus Dis, 2002, 18: 199-201)