论著

基于BCVA和角膜水肿程度探讨改良与常规小梁切除术治疗急性闭角型青光眼的临床价值

Based on BCVA and modified with conventional corneal edema degree to explore the clinical value of treatment of acute angle-closure glaucoma trabeculectomy

:366-371
 
目的 基于最佳矫正视力(BCVA)、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼(AACG)的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月,观察组视力为(0.63±0.04)logMAR,高于对照组(0.50±0.03)logMAR,眼压为(16.22±2.28)mmHg,低于对照组(19.95±2.31)mmHg(t=19.457、8.600,均P<0.05);观察组浅前房发生率为8.93%,低于对照组的26.79%(χ2=6.087,P=0.014);观察组角膜水肿状况优于对照组(Z=2.737,P=0.006);观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%(χ2=8.166、7.292、3.953、9.818,均P<0.05)。结论 较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。
Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma(AACG)based on best-corrected visual acuity(BCVA)and degree of corneal edema.Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects. According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group.Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed.Results At three months postoperatively,visual acuity in the observation group was(0.63±0.04)logMAR,which was higher than that in the control group(0.50±0.03)logMAR,and intraocular pressure was(16.22±2.28)mmHg,which was lower than that in the control group(19.95±2.31)mmHg(t=19.457,8.600,P<0.05);the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group(26.79%)(χ2=6.087,P=0.014);the corneal edema status in the observation group was better than that of the control group(Z=2.737,P=0.006);the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group(17.86%,23.21%,32.14%,and 35.71%)(χ2=8.166,7.292,3.953,and 9.818,P<0.05).Conclusions Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety.
临床诊疗

经皮微创椎弓根钉内固定和传统开放式手术治疗脊椎骨折的优劣差异

Merit and demerit of treament compared minimally invasive percutaneou pedicle screw fixtion and traditional open operation

:99-101
 
目的 分析比较经皮微创椎弓根钉内固定和传统开放式手术治疗脊椎骨折的优劣差异。方法 本研究选择我院2015年2月—2016年6月收治的脊椎骨折患者72例,按照治疗方法的不同将全部患者分成对照组(36例)和实验组(36例),两组患者分别给予传统开放式手术治疗和经皮微创椎弓根钉内固定治疗,对两组患者的临床疗效进行观察分析。结果 在手术时间、手术出血量、切口长度以及住院时间方面,实验组患者均优于对照组(P<0.05);实验组患者术后的血清肌酸激酶活性低于对照组患者(P<0.05);治疗后两组患者椎体前缘高度、Cobb's角均优于治疗前(P<0.05),但是组间比较差异无统计学意义(P>0.05)。术后两组患者均没有发生椎间隙感染、神经损伤、切口感染等并发症。结论 在对脊椎骨折患者进行治疗时,经皮微创椎弓根钉内固定治疗和传统开放式手术治疗的临床疗效比较类似,但是和传统开放式手术相比较,经皮微创椎弓根钉内固定治疗对患者的损伤更加轻微,术后恢复时间更短。
临床诊疗

卡培他滨单药维持治疗在晚期乳腺癌的疗效观察

Clinical observation of Capecitabine maintenance therapy in advanced breast cancer with the treatment of patients with advanced breast cancer

:102-105
 
目的 通过本研究观察卡培他滨单药维持治疗晚期乳腺癌患者的临床疗效。方法 纳入本院2014年4月1日—2016年9月31日收治的晚期乳腺癌(复发、转移性乳腺癌)患者64例,均经过解救化疗达到缓解并稳定,按随机数字表法将所有入选对象分为治疗组与对照组(各32例),治疗组给予口服卡培他滨维持治疗,对照组给予定期(每12周)复查评价,比较2组患者的临床疗效、PFS、OS及生活质量。结果 治疗组的临床有效率(18.75%)、临床控制率(78.13%)均显著优于仅给予定期复查的对照组(3.12%)、(56.25%)(P<0.05);治疗组维持治疗后生活质量改善者21例(65.63%),优于对照组9例(28.13%)(P<0.05);治疗组用药期间出现Ⅰ~Ⅱ度为主的手足综合征、腹泻、恶心呕吐等毒副反应,均可耐受, Ⅲ-Ⅳ度毒副反应少发生。综合评估显示治疗组中位PFS为(9.6±1.4)个月、中位OS为(20.5±2.8)个月显著长于对照组(6.1±1.5)个月、(15.8±3.1)个月,两组中位PFS、中位OS比较差异有统计学意意义(P<0.05)。结论 在晚期乳腺癌治疗中使用卡培他滨单药维持治疗具有显著的疗效,可延长患者的生存期,并提高患者的生活质量,毒副反应较轻,可作为晚期乳腺癌维持治疗的首选药物之一,值得临床推广应用。
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