目的 探讨将宫腔镜电切手术与高效孕激素治疗相联合,治疗青年女性子宫内膜癌的临床效果以及对患者生育功能的影响。方法 选取2018年5月—2020年5月我院收治的70例青年子宫内膜癌患者作为本次研究对象,根据患者入院时间单双号将患者分为对照组(n=35)和实验组(n=35),对照组患者应用高效孕激素治疗,实验组患者则在对照组的基础上联合应用宫腔镜电切术进行治疗。比较两组患者的临床疗效、再次妊娠的成功率,及血清CA125水平变化情况。结果 研究组患者在治疗后3个月的治疗有效率为94.2%,高于对照组患者治疗有效率74.2%,差异具有统计学意义(P<0.05);研究组在治疗后一年内成功受孕率91.4%高于对照组51.4%,差异具有统计学意义(P<0.05);治疗后,研究组血清CA125水平低于对照组(P<0.05)。结论 将宫腔镜电切术与高效孕激素治疗方式相结合,对治疗青年子宫内膜癌患者效果显著,能够保留患者生育功能的同时,降低血清CA125水平。

目的 探讨A超和IOL Master测量人工晶状体度数的精确性,为白内障手术提供客观的临床数据。方法 选取300例300眼老年性白内障患者,术前采用A 超和IOL Master测量眼轴长度、自动验光仪测量角膜曲率,A超组利用自动验光仪的角膜曲率数据,IOL Master组利用仪器自带的角膜曲率数据,均使用SRK-T公式计算需要植入的人工晶状体度数,观察术后3 m的屈光状态,使用自动验光仪检测患者屈光状态并分析。结果 所有被列入研究的患眼随机分为A超组和IOL Master组, A超组测得的平均眼轴长度为(23.21±0.59)mm,IOL Master组测得的眼轴长度为(23.22±0.59)mm,两组数据对比差异无统计学意义(P>0.05);利用自动验光仪测量的术前平均角膜曲率为(44.01±1.79)D,利用IOL Master测量的术前平均角膜曲率为(44.13±1.62)D,两者比较差异无统计学意义(P＞0.05);A超组和IOL Master组术后的平均绝对屈光误差(mean absolute refractive error,MAE)分别为(0.43±0.26)D、(0.42±0.17)D,两组比较差异无统计学意义(P>0.05)。结论 IOL Master在操作上略优于A超,但在人工晶体度数测量上与A超比较没有发现明显优势,不能完全取代A超,两者结合更能确保人工晶体度数测量的精确性。

Objective By discussing the accuracy of A-scan and IOL Master in intraocular lens power measurement, to offer Objective clinical data for cataract surgery.Methods Three hundred patients(300 eyes)with age-related cataract were included in the study. Before surgery,axial length was measured by A-scan and IOL Master respectively and corneal curvature was measured by auto refractometer. A-scan group used the corneal curvature data of the auto refractometer. IOL Master group used the corneal curvature data from the instrument. Intraocular lens power was calculated according to the SRK-T formula.We observed the refractive state of 3m after operation, detected and analyzed the patient's refractive data by the auto refractometer.Results All patients who were included in the study were randomly divided into A-scan group and IOL Master group.The mean axial length was (23.21±0.59) mm measured by A-scan, the mean axial length was (23.22±0.59) mm measured by IOL Master. There was no significant difference between them (P>0.05). The preoperative mean corneal curvature measured by the auto refractometer was (44.01±1.79)D. The preoperative mean corneal curvature measured by IOL Master was (44.13±1.62)D. There was no statistically significant difference between them (P＞0.05). The mean absolute refractive error ( MAE) in A－scan group was (0.43±0.26)D and in IOL Master group was (0.42±0.17)D. There was no statistically significant difference between them (P＞0. 05).Conclusion IOL Master group operated slightly better than A-scan group, but we did not find a significant advantage in intraocular lens power measurement with A-scan group. IOL Master may not completely replace A-scan. The combination of the two ensures the accuracy of the measurement in intraocular lens power.

目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

飞秒激光辅助的SMILE因其微创、准确性、安全性、可预测性、稳定性好的特点越来越受患者和术者的欢迎,随着大家对手术的期望值增加,视觉质量成为反应手术效果极其重要的因素之一,而高阶像差又是评定视觉质量尤为重要的指标。本文对飞秒激光SMILE的眼高阶像差及其影响因素进行综述。

Femtosecond laser-assisted SMILE is more and more popular with patients and the operators because of the minimal invasion, efficacy, safety, predictability and stability. But with the increase of people's expectations of the surgery, visual quality become one of the important factors which reacts operation effect extremely, and higher-order aberration is an especially important index when evaluate the visual quality. In this paper, the higher-order aberration and its influence factors of femtosecond laser-assisted SMILE were summarized.