目前Wetlab眼科手术教学采用猪眼球作为教学模型，与实际手术差别较大，且无法满足外眼手术教学的需求。通过使用带有眼球、眼外肌、眶组织、眶骨及眼睑结构的全眼模型，可高度模拟真实手术场景，覆盖更多眼科手术教学需求。基于全眼模型构建多个眼科手术教学平台，依照培养阶段设计手术课程，创建新的评价体系，改变传统将“内眼”“外眼”分开的教学理念，可使年轻医师从一开始就建立眼科“分科而不分割”的整体思维，从而使眼科手术培训更加规范和完善。
Porcine eyes have been used as animal model in ophthalmic surgery training. However, it differs greatly from real surgery and cannot meet the needs of external eye surgery teaching. Porcine orbit model with eyeball, extraocular muscles, orbital tissue, bones and eyelids can be more realistic simulation of real surgeries and cover more needs for ophthalmic surgery teaching. By setting up ophthalmic surgery teaching platforms, designing staged course and creating new assessment methods based on porcine orbit model, the traditional concept about separation of internal and external eye is changed. This helps young doctors to establish a holistic view from the very beginning,that ophthalmic surgeries should not be split because of subspeciality. In this way, ophthalmic surgery training will become more standardized and perfected.
目的：调查眼病患儿家长在患儿手术前的健康教育需求，为责任护士开展个性化、高质量的健康教育提供依据。方法：采用自制的眼病儿童手术前家长的健康教育需求调查问卷对2020年4月至2020年6月的眼病手术患儿家长进行问卷调查，并对调查结果进行统计分析。结果：家长对眼病患儿手术术前健康教育需求排名前3位的是手术治疗的效果、意义及眼病相关专科健康知识。医疗付费方式的差异、患儿年龄、疾病的差异及家长年龄、职业状态的差异对术前健康教育需求得分差异有统计学意义(P<0.05)；家长获取健康教育知识的途径以医务人员讲解和公众号等网络平台为主。结论：眼病患儿家长对患儿术前健康教育需求较高，医务工作者应丰富知识层面，加强专科学习及相关知识培训，把专科知识与健康教育有机地结合，并探索有效的线上健康教育方式，更好地为患者服务。
Objective: To investigate the health education needs of parents of children with eye diseases before operation, and to provide basis for more targeted and high-quality health education for primary nurses. Methods: A self-made questionnaire was used to investigate the health education needs of parents of children with ophthalmopathy before surgery from April 2020 to June 2020, and the results were statistically analyzed. Results: The top three of parents’ needs for preoperative health education of children with eye diseases were the effect and significance of the surgery and the related professional health knowledge of eye diseases. The differences of medical payment methods, children’s age, diseases, parents’ age, and occupational status was significant in the scores of preoperative health education needs (P<0.05). The main ways of parents obtaining health education knowledge were network platforms such as medical staff explanation and official accounts. Conclusion: The parents of children with eye diseases have a high demand for preoperative health education. Medical workers should enrich their knowledge, strengthen specialty learning and related knowledge training, organically combine professional knowledge with health education, and explore the methods of effective online health education to serve patients better.
目的：比较重力液流与主控液流2种灌注方式下行白内障超声乳化手术对青光眼患者视盘血流的影响。方法：采用随机数字表法将患者分为2组，分别为重力液流灌注组和主控液流灌注组。记录术中超声乳化累积释放能量(cumulative dissipated energy，CDE)，术后1天、1周、1个月和3个月患者最佳矫正视力(best corrected visual acuity，BCVA)、眼压、视盘血流密度及视网膜神经纤维层厚度。结果：主控液流灌注组术中CDE小于重力液流灌注组(5.6±1.3 vs 6.3±1.2，P=0.034)。术后1天重力液流灌注组视盘周围血管密度(circumpapillary vascular density，cpVD)、整个图像血管密度(whole en face image vessel density，wiVD)和视盘内血管密度(inside disc vascular density，inside disc VD)均高于主控液流灌注组(P<0.05)，其余时间点差异无统计学意义(P>0.05)。术后1周和1个月重力液流灌注组视网膜神经纤维层厚度大于主控液流灌注组(P<0.05)，术后1天和3个月未见明显差异。结论：相较于传统的重力液流灌注，主控灌注能够在青光眼患者白内障超声乳化手术中减少超声能量的使用，术后早期可减轻由术中高眼压引起的视盘炎症性充血，可以减轻对视网膜神经纤维层的影响。
Objective: To compare the influence of active versus passive phacoemulsification fluidics systems on optic disc blood flow in patients with glaucoma. Methods: Patients were divided into 2 groups by a random number table method, namely the active fluidics system group and the passive fluidics system group. The intraoperative cumulative dissipated energy (CDE) was recorded, and the best corrected visual acuity (BCVA), intraocular pressure, optic disc blood flow density and retinal nerve fiber layer thickness were measured at the follow-up of 1 day, 1 week, 1 month and 3 months. Results: During phacoemulsification, CDE in the active fluidics system group was lower than that in the passive fluidics system group (5.6±1.3 vs. 6.3±1.2, P=0.034). One day after the surgery,the circumpapillary vessel density (cpVD), whole image vessel density (wiVD) and inside disc vascular density(inside disc VD) in the passive fluidics system group were higher than those in the active fluidics system group(P<0.05), and the differences were not statistically significant at the rest of the follow-ups (P>0.05).The retinal nerve fiber layer in passive fluidics system group was thicker than that in active fluidics system group at the follow-ups of 1 week and 1 month (P<0.05), and the difference was not statistically significant at the follow-up ofs 1 day and 3 months. Conclusion: Compared with the traditional passive fluidics system, the active fluidics system can reduce the CDE during phacoemulsification surgery. It can reduce the inflammatory congestion of the optic disc caused by intraoperative high intraocular pressure on the early postoperative stage. In addition, it can also protect retinal nerve fiber layer.
目的：探讨以岗位需求为导向的培训模式在眼科手术室护士上岗前消毒供应专科专项培训中的应用效果。方法：手术室上岗前护士共44名，按随机分配原则，其中23名为实验组，另外21名为对照组。实验组以医院消毒供应中心三大行业标准和医院消毒技术规范为理论依据，以手术室护理岗位需求为目标，制定针对性培训内容，采用多方式培训方法，在消毒供应中心培训3个月考核合格后调入手术室。对照组直接调入手术室工作。采用手术室带教老师对新上岗护士满意度调查作为评价指标。结果：23名学员的理论知识考核、技术操作考核全部合格，小讲课顺利完成。手术室带教老师对实验组的满意度明显高于对照组。结论：建立以岗位需求为导向的眼科手术室护士消毒供应专科培训模式，有助于提高新上岗的手术室护士工作适应性，并提升手术室护士对专科器械的管理能力。
Objective: To explore the application effect of job demand-oriented training model in specialized training of sterile supplying for nurses in the ophthalmic operation room. Methods: A total of 44 nurses who would work in the operating room were randomly divided into the experimental group (n=23) and control group (n=21). Based on the three industrial standards of Central Sterile Supply Department (CSSD) and the technical specifications of disinfection in hospital, and targeting the job requirements of operating room nursing, the experimental group formulates specific training contents and adopts various training methods. The experimental group was transferred to the operating room after being trained in CSSD for 3 months and passing the examination. The control group was transferred directly to the operating room. The degree of satisfaction from the teachers of operating room to new nurses was used as the evaluation index. Results: All the 23 students passed the examination of theoretical knowledge and technical operation, and the small lectures were completed successfully. The degree of satisfaction from teachers in operating room to trainees was obviously higher than that of untrained nurses. Conclusion: The establishment of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room is helpful to improve the work adaptability of the newly-hired nurses in the operation room. It also helps the nurses in the operation room to enhance the management ability on the specialized instruments.
目的：探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia，AACE)的治疗效果。方法：随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者，分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果：将43例患者纳入研究，其中男27例(63%)，女16例(37%)，手术年龄9~53(23.7±11.4)岁，术前斜视持续时间3个月~11年(24.8±24.5个月)，术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD，P<0.001；近距差值(11.4±6.7) PD，P<0.001]；术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD，末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001)，38例(88%)患者无眼位偏斜，5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001)，末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论：以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果，未见眼位过矫者；术后立体视恢复与术前近距立体视和术前斜视持续时间相关，提示适当早期手术可能有助于术后立体视功能的恢复。
Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.
目的：了解行全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction，SMILE)患者围手术期的体验感受。方法：采用定性调查的方法，选取广东省某医院的15名行SMILE的患者，进行半结构式访谈，将患者围手术期体验归纳为顾虑、紧张、疼痛、担心、放松5个主题概念，用现象学分析法整理、分析资料。结果：把5种体验汇总制成韦恩图，通过韦恩图提炼发现有1人有围手术期5种感受，3位有紧张、疼痛、担心、放松4种心理感受，2位只有紧张的感受，而无其余感受。结论：行SMILE患者的围手术期具有多种体验感受，分析不同感受状态和因素，为眼科医护人员对于寻求SMILE手术的患者做好围手术期的服务提供依据。
Objective: To investigate the perioperative experience after small incision lenticule extraction (SMILE). Methods: A semi-structured interview was conducted in 15 patients who underwent SMILE surgery in Zhuhai People’s Hospital.The data were collected and analyzed by phenomenological analysis. Results: The perioperative feelings of patients were summarized into five categories: concern, tension, pain, worry and relaxation. These feelings were compiled and extracted by Venn diagram. One patient had all five categories of feelings during the perioperative period. Three patients experienced four psychological feelings of tension, pain, worry and relaxation, and 2 patients had only nervous feelings during the full femtosecond operation period. Conclusion: Patients undergoing SMILE have avariety of experience feelings during perioperative period. Analysis of different feeling states and factors will provide evidence for ophthalmic medical staff to provide perioperative services for patients seeking SMILE surgery.
目的：了解白内障手术患者的临床分布特点，为基层医院白内障防治工作提供信息参考。方法：选取2019年1月至2019年1 2月在锦州医科大学附属第三医院眼科手术医治的白内障患者892例1 008眼。查阅相关病历资料，收集姓名、性别、年龄、手术眼别、入院时间、有无糖尿病史；术前视力、角膜内皮细胞密度、眼轴、晶状体混浊类型及白内障病因；手术方式、人工晶状体(intraocular lens，IOL)、术中并发症；术后第1天眼压、视力、眼部情况，进行统计学描述及分析。结果：入 选892例1 008眼，其中男357例401眼，女535例607眼，年龄(71.17±10.28)岁，90.7%的患者病因为年龄相关性白内障。入院时间集中在3~6月和9~12月。不同年龄段白内障患者具有各自的眼部特征。白内障类型与年龄差异有统计学意义(P<0.05)，相比皮质性、后囊膜下性，核性白内障患者入院年龄偏大。白内障类型与性别、有无糖尿病史差异无统计学意义(P >0.05)。白内障患者选择最多的手术方式是超声乳化吸除术联合IOL植入术，术中并发症少，术后恢复快。结论：白内障的防治工作任重道远。手术多为年龄相关性白内障患者，入院时多年龄偏大，视力偏低，错失了手术最佳时机。不同年龄段、不同类型白内障患者具有不同的特征。超声乳化吸除术因其优势成为患者首选手术方式。
Objective: To understand the clinical distribution characteristics of cataract surgery patients and provide reference for cataract prevention and treatment in primary hospitals. Methods: From January 2019 to December 2019, 892 cataract patients (1 008 eyes) were selected from the Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University. Medical records were collected, including patient’s name, gender, age, surgical eye, admission time and history of diabetes, preoperative vision, corneal endothelial cell density, eye axis, phacoscotasmus type and cataract etiology, surgery method, intraocular lens, intraoperative complications, intraocular pressure, visual acuity and eye recovery on the first day after operation. These data were statistically described and analyzed. Results: A total of 892 cataract patients (1 008 eyes) were included, including 357 males (401 eyes) and 535 females (607 eyes), with the average age of (71.17±10.28) years old. The 90.7% patients cause of disease was age-related cataract. Admission time of all patients was mainly in March–June and September– December. Cataract patients of different ages had their own ocular characteristics. There was a statistically significant difference between the type of cataract and age (P<0.05). Compared with the cortical patients and posterior subcapsular patients, nuclear cataract patients were older at admission. There was no significant difference in the type of cataract between the gender and the patients with diabetes or not (P>0.05). The most frequently selected surgical method for cataract patients was phacoemulsification and intraocular lens implantation, which has the advantages of less intraoperative complications and rapid postoperative recovery. Conclusion: We still have a long way to go in the prevention and treatment of cataract. Most of the operations were performed on age-related cataract patients, and most of them were older and had low vision when they were admitted to hospital, so the optimal timing of the operation was missed. Patients of different age groups and different types of cataract have different characteristics. Phacoemulsification is the first choice because of its own advantages.
目的：评价手术视频辅助Wetlab眼睑手术教学的效果。方法：回顾性分析2021年4月至2021年9月在中山大学中山眼科中心住院医师规范化培训学员中使用全眼模型开展Wetlab外眼手术教学的情况。对照组(12人)采用传统教学方法，实验组(15人)在传统教学方法的基础上引入手术视频辅助教学，对学员第3、6、9次练习视频进行评分，分析教学效果。结果：2组学员的基线水平与学习曲线相似，练习第3次到第6次之间评分提高快(对照组P3~6=0.001，实验组P3~6<0.001)，第6次到第9次之间提高速度放缓(对照组P6~9=0.007，实验组P6~9=0.012)。对照组学员在练习第3次用时更长[(80.3±16.1) min]，随着练习次数增多，用时逐渐缩短并保持稳定(P3~6=0.040，P6~9=0.886，P3~9=0.020)，而实验组学员在练习第3次用时更短[(71.7±15.0) min]，练习过程中保持稳定(P3~6=0.568，P3~9=0.519)。结论：手术视频辅助教学有助于学员熟悉手术操作，提高练习效率。
Objective: To assess the efficacy of video-assisted Wetlab eyelid surgery teaching. Methods: From April 2021 to September 2021, the porcine orbit model was used to conduct a Wetlab teaching course on eyelid surgeries among trainees of standardized training for residents in Zhongshan Ophthalmic Center, Sun Yat-sen University. The control group (12 trainees) used conventional teaching methods. Video-assisted teaching was offered to the test group (15 trainees) based on conventional teaching methods. The videos records of the 3rd, 6th, and 9th practices were scored to analyze the teaching efficiency. Results: Trainees from the 2 groups showed a simila baseline and learning curve. Rapid improvement was found between the 3rd and 6th practice (P3–6=0.001 in control group, P3–6<0.001 in test group). The increment was slower between the 6th and 9th practice (P6–9=0.007 from control group, P6–9=0.012 from test group). Longer time was required by trainees from the control group at the 3rd practice [(80.3±16.1) min]. As they practiced more, the time required gradually decreased and remained stable (P3–6=0.040, P6–9=0.886, P3–9=0.020 from control group). Trainees from the test group spent less time at the 3rd practice [(71.7±15.0) min]. The time remained stable during all practices (P3–6=0.568, P3–9=0.519 from test group). Conclusion: Video-assisted teaching can help trainees get familiar with surgical operations and improve the efficiency of practices.
目的：探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法：采用便利抽样法抽取行角膜移植日间手术的173例患者，采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果：角膜移植日间术后患者延续护理需求得分为88.13±15.55，其中，对疾病相关知识的需求得分最高，为4.39±0.66，对心理护理的需求得分最低，为2.72±1.18；在延续护理实施方式方面，74.6%患者倾向于电话随访，只有5.8%倾向于上门服务；在影响因素方面，婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论：角膜移植日间术后患者的延续护理需求较高，应根据患者延续护理需求及影响因素进行个性化指导，以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
目的：探讨多元化宣教在提高眼科日间手术患者眼部用药正确率及满意度的应用效果。方法：采用便利抽样的方法，选取中山大学中山眼科中心2020年10至12月收治的200例眼科日间手术患者眼部用药的执行者为对象，将10至11月收治的100例日间手术患者眼部用药的执行者纳入对照组，将12月收治的100例日间手术患者眼部用药的执行者纳入试验组。对照组采取传统宣教方式，试验组应用多元化宣教模式进行健康教育。采用自制的健康教育需求调查表调查眼部用药执行者的健康教育需求，采用眼部用药执行评价表、健康宣教满意度调查表评价干预效果。结果：采用多元化宣教方式干预后，试验组患者眼部用药正确率(94%)高于对照组(35%)，差异具有统计学意义(P<0.05)。试验组对多元化宣教满意度得分明显高于对照组，差异具有统计学意义(P<0.05)。结论：多元化宣教模式可提高眼科日间手术患者眼部用药正确率，提高患者及家属的满意度，值得临床推广应用。
Objective: To explore the effect of diversified education on improving the accuracy and satisfaction of eye medication in patients undergoing ophthalmic ambulatory surgery. Methods: A total of 200 practitioners of administering eye medication after undergoing ambulatory surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from October to December 2020 were investigated by convenience sampling, 100 practitioners admitted from October to November were included in the control group, and 100 practitioners were included in the experimental group. The control group adopted the traditional method of education, while the experimental group applied diversified education mode to carry out health education. The health education needs of the patients were investigated by the self-made health education needs questionnaire, and the effect of intervention wasevaluated by the eye medication implementation evaluation form and health education satisfaction questionnaire. Results: After the intervention, the correct rate of eye medication in experimental group (94%) was higher than the control group (35%) with a statistical difference (P<0.05). The satisfaction score about diversified education in experimental group was significantly higher than the control group with a statistical difference (P<0.05).Conclusion: Diversified education model can improve the accuracy of administering eye medication in patientsundergoing ophthalmic ambulatory surgery, and the satisfaction in patients and their families is significantly improved. It is worthy of clinical application.
