目的：探讨标准化沟通模式(SBAR)在眼球穿通伤患者护理交班中的应用效果。方法：60例患者作为对照组，使用传统口头方式交班；60例患者作为观察组，使用SBAR沟通模式进行交接。比较两组交班耗时、两组护士对患者病情掌握程度以及患者对护理服务满意度的差异。结果：观察组与对照组比较，上述指标差异具有统计学意义(P<0.05)。结论：采取SBAR沟通模式交班有助于降低在眼球穿通伤护理中的不良事件发生率，保障了护理质量，提高了交接班效率和患者满意度，适宜推广应用。
Objective: To evaluate the SBAR communication model in the nursing care handover of patients with penetration injuries of eyeball. Methods: Transfer time, receivers’ information retention, and patient’s satisfaction were compared between two groups of patients with penetration injuries of eyeball. A total of 60 patients were handled with the traditional oral communication handover as comparison group and other 60 patients were handled with the SBAR handover as intervention group. Results: When comparing intervention group with comparison group, statistically significant improvements (P<0.05) were observed in all three factors tested. Conclusion:Implementing the communication tool SBAR in the nursing care of patients with penetration injuries of eyeball reduces rate of adverse events, improves patient care quality, enhances transfer efficiency, and boosts patient’s satisfaction.
目的：分析复发与初发睑板腺囊肿患者的睑板腺组织形态学改变在活体共聚焦显微镜(in vivo confocal microscope，IVCM)下的表现及特点。方法：采用横断面研究方法，选取2018年10月至2019年4月在汕头大学·香港中文大学联合汕头国际眼科中心门诊就诊的10例复发性睑板腺囊肿患者、10例初发性睑板腺囊肿以及10例对照组作为观察对象。所有对象行眼科常规检查及IVCM检查。IVCM检测指标包括睑板腺开口面积、开口最短径、开口最长径、睑板腺开口附近腺管形态、睑板腺腺泡样结构形态，分析比较三组的计量指标。结果：复发性睑板腺囊肿组睑板腺开口短径(109.08±49.96) μm，开口长径(144.95±68.10) μm，开口面积为11 621.62 (3 976.49~24 828.82) μm2 ；初发性睑板腺囊肿组睑板腺开口短径(101.53±29.55) μm，开口长径(130.08±45.21) μm，开口面积10 615.07(5 813.29~18 275.44) μm2 ；对照组睑板腺开口短径(44.14±14.37) μm，开口长径(55.98±13.46) μm，开口面积2 233.29(1 437.72~2 945.65) μm2 。与对照组相比，复发性、初发性睑板腺囊肿组睑板腺开口短径、开口长径及开口面积均明显扩大，差异有统计学意义(P<0.05)；复发与初发睑板腺囊肿组之间差异不具有统计学意义(P>0.05)。复发性睑板腺囊肿组睑板腺腺管扩张，周边腺泡样结构纤维组织增生，伴有炎症细胞浸润。初发性睑板腺囊肿组睑板腺腺管扩张，周边腺泡样结构未见明显纤维组织增生。结论：IVCM可在活体下观察睑板腺囊肿患者睑板腺形态学上的微观改变，复发性睑板腺囊肿睑板腺腺泡样结构形态与初发性睑板腺囊肿表现有差异。
Background: To analyze the morphological changes of meibomian glands in patients with recurrent and primary meibomian gland cyst under in vivo confocal microscope (IVCM). Methods: A cross-sectional study was performed in Shantou International Eye Center from September 2018 to April 2019. Ten patients with recurrent meibomian cyst, 10 patients with primary meibomian cyst and 10 control subjects were selected in this clinical trial. All subjects received routine ophthalmologic examination and IVCM examination. IVCM examination parameters included open area of meibomian gland, and the maximum and minimum diameter of meibomian gland opening. Relevant parameters were analyzed and statistically compared among different groups. Results: The average minimum diameter of meibomian glands opening in the recurrent meibomian gland cyst group was (109.08±49.96) μm, the average maximum diameter of meibomian glands opening was (144.95±68.10) μm, and the median open area of meibomian gland was 11 621.62 (3 976.49–24 828.82) μm2 . In the primary meibomian gland cyst group, the average minimum diameter of meibomian glands opening was (101.53±29.55) μm, the average maximum diameter of meibomian glands opening was (130.08±45.21) μm, and the median open area of meibomian gland was 10 615.07 (5 813.29–18 275.44) μm2 . The opening of meibomian glands in both the recurrent and primary meibomian gland cyst groups was enlarged, which significantly differed from that in the control group (both P<0.05). No statistical significance was noted between the recurrent and primary meibomian gland cyst groups (P>0.05). The acinus structure around the gland tube was manifested with serious hypertrophic scar complicated with inflammatory cell infiltration. Conclusion: IVCM can detect the morphological changes of meibomian glands in meibomian gland cyst patients. The IVCM findings of recurrent and primary meibomian gland cyst are different.
目的：分析眼专科医院患者突发急症现状，并探讨防控措施。方法：回顾性分析2017—2018年中山眼科中心82例突发急症事件，具体分析突发急症事件的特点、处置情况及患者转归。结果：眼专科医院中最常见的突发急症事件为药物不良反应(n=38，46.3%)，其后依次是晕厥(28.0%)、心脑血管急症(8.3%)、意外事件(6.1%)，其中药物不良反应涉及的相关药物最多见于荧光素钠注射液(n=16，42.1%)、局部神经阻滞麻醉相关药物(n=7，18.4%)。突发急症事件集中分布于工作时段8:00—18:00(n=74，91.3%)，非工作时段多见于药物不良反应(n=3，42.9%)及心脑血管急症(n=3，42.9%)。门诊是突发急症事件最常发生的场所(n=53，64.6%)，其后依次是住院病房(22.0%)、手术室(11.0%)。患者突发急症危急程度轻、中、重度分别占92.7%，4.9%，2.4%。50%的患者需要综合医院急诊人员配合抢救或至综合医院进一步诊治。结论：通过优化患者诊治流程，缩短在院时间，医护人员提高预警意识，明确各岗位潜在急症风险，可降低突发急症事件发生风险。发挥麻醉师专业优势，提高院内应急处理能力，同时签约定点综合医院急救服务，为患者提供快速、准确、高效的救护，保障患者生命安全。
Objective: To analyze the status of medical emergencies of patients in ophthalmic hospitals and put forward suggestions on their prevention and control measures. Methods: The medical emergencies of 82 patients in ophthalmic hospitals in 2017 and 2018 was been analyzed retrospectively, and the characteristics and treatment of emergencies as well as the metastasis and progression of the disease in patients were analyzed specifically.Results: Medical emergencies were caused by druginduced adverse reaction (n=38, 46.3%), syncope (28.0%), cardiovascular emergency (8.3%), accidents (6.1%) in sequence. Fluorescein sodium (n=16, 42.1%) and local anesthesia drugs for nerve block (n=7, 18.4%) were the most common drugs related to drug adverse reaction. Most cases happened at 8:00—18:00 (n=74, 91.3%), and drug adverse reaction and cardiovascular and cerebrovascular emergencies were most common at 18:00—8:00. Medical emergencies happened in outpatient department (n=53,64.6%), wards (22.0%) and operation rooms (11.0%). There were mild emergencies (92.7%), moderate emergencies (4.9%) and severe emergencies (2.4%) in patients. Among them, 50% of patients need first aid by doctors from general hospitals or to be transferred to the general hospital for further treatment. Conclusion: Through optimizing process, shortening the hospital stay, identifying potential risks and enhancing medical workers’ awareness of safety, the risk of medical emergencies can be reduced. We should give full play to the professional advantages of anesthesiologists,improve the emergency handling capacity of the hospital, and contract the emergency services of designated general hospitals to provide rapid, accurate and efficient rescue for patients to ensure the life safety of patients.
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：探讨赋能教育模式在干眼患者健康教育中的应用价值。方法：选取2017年6月至12月期间首诊于南方医科大学珠江医院眼科的干眼患者，按照完全随机分配法分为试验组(n=73)及对照组(n=73)，试验组采用赋能教育模式，对照组采用传统健康教育方式。经治疗1周、1个月、2个月及6个月后，分别随访并记录每组患者的眼表疾病指数(ocular surface disease index，OSDI)、泪膜破裂时间值(tear film break up time，BUT)，同时记录患者家庭护理(清洁睑缘、热敷、睑板腺按摩)频率以及复诊频率。结果：赋能教育组家庭护理频率及复诊频率均优于传统教育组(P<0.05)。治疗前两组OSDI和BUT差异均无统计学意义(P>0.05)，但试验组OSDI随时间的推移呈下降趋势，BUT值呈上升趋势；而对照组OSDI以及BUT值的变化均不明显。结论：运用赋能教育模式有助于提高干眼患者治疗的依从性，提高患者的家庭护理频率和复诊频率，显著改善患者的眼表情况，进而提高长期治疗效果。
Objective: To evaluate the application value of empowerment education mode in health education for patients with dry eye syndrome. Methods: Patients with dry eye syndrome were recruited from Department of Ophthalmology, Zhujiang Hospital, Southern Medical University from June 2017 to December 2017. All patients were randomly divided into the experimental group (n=73), educated with empowerment education mode, and control group (n=73), treated with traditional health education. Patients were followed up after 1 week, 1 month,2 months and 6 months, respectively. Data were collected in each follow-up visit including ocular surface disease index (OSDI), tear film break up time (BUT), the frequency of home care (cleaning eyelid margin, hot compress,palpebral gland massage) and re-visit frequency. Results: The OSDI and BUT were similar between two groups before corresponding treatment (P>0.05). After the treatment, patients in the experimental group showed a downtrend in the OSDI and uptrend in the BUT. No significant changes were found in the control group during the follow-up. The frequency of family nursing and re-visit in the experimental group was statistically higher than that in the control group. Conclusion: The application of empowering education mode can improve the compliance of dry eye patients, improve the frequency of home care and follow-up visit, and mitigate the ocular surface of patients, thereby enhancing the long-term efficacy.
目的：比较四种不同原理的仪器在暗室中对年龄相关性白内障患者Kappa角测量的一致性。方法：对年龄相关性白内障术前60例(60只眼)，暗室中适应10 min后，分别应用iTrace视觉分析仪、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径和Kappa角。四种仪器间所测量的数据比较采用单因素方差分析检验和Kruskal-Wallis非参数检验，一致性比较采用Bland-Altman分析。结果：iTrace、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径分别为(4.64±0.71) mm，(2.96±0.47) mm，(4.86±0.76) mm，(4.66±0.92) mm；Kappa角大小分别为(0.227±0.121) mm，(0.161±0.09) mm，(0.2±0.124) mm，(0.203±0.104) mm；大于0.5 mm的Kappa角比例分比为3.33%、3.33%、1.67%、1.67%；Pentacam和iTrace的Kappa角测量结果有统计学意义(P=0.001)，Pentacam和Lenstar900、IOLMaster700的Kappa角测量结果差异无统计学意义(P=0.044，0.036)，其他三种仪器之间Kappa角测量结果差异均无统计学意义(P=0.181，0.245，0.860)； 60例被检测者对iTrace、PentacamHR、Lenstar900、IOLMaster700四种仪器测量过程中光强度主观评分结果显示60例(100%)被检测者认为Pentacam HR在测量过程中有明显的不适感，40例(66.67%)被检测者认为IOLMaster700检测过程中舒适感最好，结果差异有统计学意义(χ2=191.236，P<0.001)。结论：Pentacam HR与iTrace、Lenstar900和IOLMaster700三种仪器在暗室中Kappa角的测量结果一致性稍差，临床上需谨慎替换使用。
Objective: To compare the consistency of Kappa Angle measurements in patients with age-related cataracts using four instruments of different principles in a dark room. Methods: Sixty cases (60 eyes) of age-related cataract were adapted in the darkroom for 10 minutes. The pupil size and angle Kappa were measured by iTrace, Pentacam HR, Lenstar900 and IOLMaster700. One-way ANOVA test and Kruskal-Wallis nonparametric test were used to compare the measured data among the four instruments, and Bland-Altman analysis was used for consistency comparison. Results: The measured pupil diameters of iTrace, Pentacam HR, Lenstar900 and IOLmaster700 were 4.64±0.71 mm, 2.96±0.47 mm, 4.86±0.76 mm and 4.66±0.92 mm. The Angle Kappa sizes were 0.227±0.121 mm, 0.161± 0.09 mm, 0.2±0.124 mm, 0.203±0.104 mm. The proportion of angle Kappa larger than 0.5 mm was 3.33%, 3.33%, 1.67% and 1.67%. The measurement results of angle Kappa between Pentacam and iTrace were statistically significant (P=0.001). There was no significant difference in the measurement results of angle Kappa between Pentacam and Lenstar900, Pentacam HR and IOL-Master700 (P=0.044, 0.036). There was no significant difference in the results of angle Kappa measurement among the other three instruments. The subjective score of light intensity in the process of measurement of iTrace, Pentacam HR, Lenstar900 and IOLMaster700 showed that during the process of measurement, 60 cases (100%) experienced obvious discomfort caused by the light intensity in Pentacam HR, while 40 cases (66.67%) felt comfort in IOLMaster700. The differences among the subjective score of light intensity of four instruments were statistically significant (P<0.001). Conclusion: The consistency of the measurement results of Kappa angle between Pentacam HR and iTrace, Lenstar900, IOLMaster700 in the darkroom is relatively poor, so it is necessary to be careful to replace them in clinic.
目的：评估与原发性慢性青光眼患者生活质量最具相关性的视觉指标。方法：回顾性病例系列研究。收集2010年3月至2010年8月就诊于首都医科大学附属北京同仁医院且符合入选及排除标准的原发性慢性闭角型青光眼和原发性开角型青光眼患者131例262只眼。采用Humphrey Field AnalyzerII 750i型视野分析仪对入选患者分别进行单眼Central 24-2程序和Esterman双眼视野检查程序(Esterman Binocular Visual Field Test，EBVFT)各两次检查，以保证所得数据的可靠性。使用LogMAR视力表检查并记录受试者日常单眼生活视力和日常双眼生活视力、非接触式眼压计测量眼压、直接眼底镜检查视神经的杯盘比。记录病史及目前所使用抗青光眼药物，角膜及晶状体状态。应用视功能相关生活质量量表-25(25-Item National Eye Institute Visual Function Questionnaire，VFQ-25)对患者进行生活质量评估，并将双眼日常生活视力、较好眼生活视力、较差眼视野MD(mean defect)值、较好眼视野MD值、(Esterman Visual Field Test，EVFT)效用值和VFQ-25得分进行相关性分析。结果：共有131例受试者符合入选条件。在患者生存质量的统计中，自我评价视力、近距离活动、远距离活动、社会功能、依赖程度、色觉、视野这7项得分较好，即受试者完成该7项的能力较高。VFQ-25总分与EBVFT效用值成正相关(r=0.24998，P=0.004<0.05)，与双眼日常生活视力成负相关(r=?0.37778，P<0.0001)，与较差眼视野MD值成正相关(r=0.22917，P=0.0187<0.05)，与较好眼生活视力、较好眼视野、较差眼生活视力无明显相关关系。结论：原发性慢性青光眼患者双眼视觉(双眼视野和双眼日常生活视力)和VFQ-25有良好的相关性，可用于评估慢性青光眼患者的生活质量。
Objective: To assess the correlation between the Esterman binocular visual field (EBVF) and the visual function quality of life (VFQ) in primary chronic glaucoma patients. Methods: It is a retrospective case series study.One hundred and thirty-one patients, that is to say, two hundreds and sixty-two eyes, with primary chronic glaucoma satisfying the methodological criteria were recruited for this study, who were chosen from Beijing Tongren Hospital, Capital Medical University from March 2010 to August 2010. The Humphrey Field Analyzer Model II 750i (Humphrey Instruments, Zeiss Company) was used to perform an Esterman binocular visual field test (EBVFT) and bilateral monocular full-threshold central visual field testing using the 24-2 SITA Standard program. Visual acuities were examined by logarithm of the minimum angle of resolution (logMAR) scale. Intraocular pressure and cup-disc ratio were also recorded. The history with glaucoma and anti-glaucoma drugs, and the state of the cornea and crystalline lens were also remarked. All interviews were administered face to face by the same experienced interviewer, by using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25). Agreement between the scores from these tests and the VFQ-25 was evaluated. Results: A total of 131 patients were recruited. In the statistics of the quality of life, seven domain scores of the VFQ-25 (self-assessment vision, color vision, near action, distant action, social function, mental health and peripheral vision) were better than the others, which meant the ability of completing the seven domain was higher. Substantial agreement was found between the composite score of the VFQ-25 and the Esterman test (r=0.24998, P=0.004<0.05), strong negative correlation was found between the composite score of the VFQ-25 and the binocular visual acuity of daily life (r=?0.37778, P<0.0001), and positive correlation was found between the composite score of the VFQ-25 and the MD of the worse eye (r=0.22917, P=0.0187<0.05).Conclusion: In this sample of clinic-based patients with primary chronic glaucoma, the efficiency score of the binocular visual field tests correlated well with the composite score of the VFQ-25. Binocular visual function can be well used in evaluating the quality of life of the glaucoma patients.
目的：应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况，探讨血流变化与青光眼的关系。方法：选取2012年1 2月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primary angle closure glaucoma，PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma，POAG)患者8例(10只眼)，分别设为PACG组和POAG组；同时，选取1 0例1 0只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查，观察眼动脉(ophthalmic artery，OA)、视网膜中央动脉(central retinal artery，CRA)、睫后短动脉(short posterior ciliary artery，SPCA)的血流动力学指标，包括收缩期最大血流速度(peak systolic velocity，PSV)、舒张末期血流峰值速度(diastolic peak velocity,EDV)、血流阻力指数(resistance index，RI)、造影剂到达时间(arrival time，AT)及消退时间(departure time，DT)等指标，并对结果进行统计学分析。结果：超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035)，PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010)；彩色多普勒测定PACG组及POAG组的OA和SPCA，以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003)；同时，PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论：彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群，为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。
Objective: This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), to investigate the association between the blood flow changes and glaucoma. Methods: Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients (20 eyes, PACG group), 8 POAG patients(10 eyes, POAG group) who were diagnosed in the Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University from Dec. 2012 to Mar. 2014. The normal eyes from 10 persons were selected as control group. The flow velocity of ophthalmic artery, central retinal artery, and posterior ciliary artery were observed, including the peak systolic velocity, diastolic peak velocity, resistance index, and the arrival time and departure time of the ultrasound microbubbles (SonoVue). Results: Compared to control group, the arrival timeof the ultrasound microbubbles (SonoVue) of ophthalmic artery of patients with POAG increased (P=0.035),and the departure time of ophthalmic artery of patients with PACG and POAG increased (P=0.010). Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased (P=0.003). Meanwhile, the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group (P<0.001). Conclusion: The flow velocity of ocular vascular was worse than that of normal group respectively. This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.
目的：测量黄斑区视网膜神经节细胞层和内界膜-视网膜色素上皮层厚度，分析其与新发缺血性脑卒中的相关性。方法：采用前瞻性研究，选择2021年12月至2022年3月在潍坊医学院附属医院体检的健康者30例(60眼)为对照组(A组)；选择同期收治且年龄匹配的新发缺血性脑卒中患者30例(60眼)为卒中组(B组)。比较两组黄斑区神经节细胞层(ganglion cell layer,GCL)和内界膜-视网膜色素上皮层(inner limiting membrane-Retinal pigment epithelium,ILM-RPE)厚度及平均GCL厚度/ILM-RPE平均容积厚度(GCL/ILM-RPE厚度比)。结果：共纳入120只眼，A、B组分别60只眼。A组的平均GCL为(83.5±4.7)μm，B组的平均GCL厚度为(78.7±10.5)μm，组间比较差异有统计学意义(P<0.001)。A组的GCL最小厚度为(80.4±4.4)μm，B组的GCL最小厚度为(70.7±16.3)μm，组间比较差异有统计学意义(P<0.001)。A组的ILM-RPE中心子区厚度为(247.5±19.8)μm，B组的ILM-RPE中心子区厚度为(241.6±36.3)μm，组间比较差异无统计学意义(P=0.393)。A组的ILM-RPE平均容积厚度为278.4±9.8μm，B组的ILM-RPE平均容积厚度为(278.5±15.3)μm，组间比较差异无统计学意义(P=0.448)。A组的GCL/ILM-RPE厚度比为0.300 3±0.012 2，B组的GCL/ILM-RPE厚度比为0.286 2±0.028 6，组间比较差异有统计学意义(P<0.001)。结论：缺血性脑卒中影响GCL厚度和GCL/ILM-RPE厚度比， GCL厚度和GCL/ILM-RPE厚度比与新发缺血性脑卒中可能有关。
Objective: To measure the thickness of retinal ganglion cell layer and inner limiting membrane-retinal pigment epithelium layer in the macular region, and analyze its correlation with new-onset ischemic stroke. Methods: By using a prospective study, 30 healthy subjects (60 eyes) who underwent physical examination in Affiliated Hospital of Weifang Medical University from December 2021 to March 2022 were selected as the control group (Group A). Thirty age-matched patients with new-onset ischemic stroke admitted at the same time (60 eyes) were selected as the stroke group (Group B). The ganglioncelllayer (GCL) and innerlimitingmembrane-Retinalpigmentepithelium (ILM-RPE) were compared between the two groups. It included the thickness and mean GCL thickness/Mean Volume thickness of ILM-RPE (GCL/ILM-RPE thickness ratio). Results: A total of 120 eyes were included, with 60 eyes in group A and B. The average GCL thickness in group A was (83.5±4.7) μm, and the average GCL thickness in group B was (78.7±10.5) μm,and the difference between groups was statistically significant (P<0.001). The minimum thickness of GCL in group A was (80.4±4.4) μm, and the minimum thickness of GCL in group B was (70.7±16.3) μm, showing statistical significance(P<0.001). The thickness of the central subregion of ILM-RPE in group A was (247.5±19.8) μm, and the thickness of the central subregion of ILM-RPE in group B was (241.6±36.3) μm, and the difference was not statistically significant between two groups (P=0.393). The mean volumetric thickness of ILM-RPE in group A was (278.4±9.8) μm, and the mean volumetric thickness of ILM-RPE in group B was (278.5±15.3) μm, and the difference was not statistically significant (P=0.448). The GCL/ILM-RPE thickness ratio of group A was (0.300 3±0.012 2), and that of group B was (0.286 2±0.028 6), showing a statistical difference between groups (P<0.001). Conclusion: Ischemic stroke affects the GCL thickness and the thickness ratio of GCL/ILM-RPE, which may be related to new-onset ischemic stroke.
目的：分析肺炎克雷伯菌导致内源性眼内炎在糖尿病患者中的临床特征，总结治疗经验及评估其预后。方法：回顾性病例分析2019年1月至2022年3月期间就诊于山东中医药大学附属眼科医院的肺炎克雷伯菌导致的内源性眼内炎糖尿病患者7例(8眼)。分析其年龄、性别、感染灶来源、就诊时间、治疗前后视力、眼压、裂隙灯检查、眼底检查、眼科B超、治疗方式、感染控制及复发情况。结果：7例患者年龄(63±17.6)岁。男性5例(71.4%)，女性2例(28.6%)。术后7眼(87.5%)视力NLP，1眼(12.5%)LogMAR视力0.2。视力与患者就诊时间及就诊时视力有关。6例(85.7%)就诊前发热。8眼(100%)结膜混合充血，1眼(12.5%)前房积脓。7眼(87.5%)行玻璃体切割术联合玻璃体腔注药术，1眼(12.5%)行单纯玻璃体腔注药术。8眼感染均控制，无眼球摘除。随访期间眼压正常，无感染复发。结论：肺炎克雷伯菌是内源性眼内炎的主要致病菌，易在糖尿病人群中发生。发病迅速进展快，早期临床表现不典型易被误诊，其预后和病程的长短及治疗的时机密切相关，尽早地治疗可挽回部分视力。
Objective: To analyze the clinical characteristics of endogenous endophthalmitis caused by Klebsiella pneumoniae in diabetic patients, and summarize the treatment experience and evaluate its prognosis. Methods: A retrospective case analysis was performed on 7 patients (8 eyes) with endogenous endophthalmitis caused by Klebsiella pneumoniae, who were admitted to the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to August 2022. The age, gender, origin of infection, time of treatment, visual acuity before and after treatment, intraocular pressure, slit lamp examination, fundus examination, ophthalmic B-mode ultrasound, treatment methods, infection control and recurrence were analyzed. Results: The mean age of the seven patients was (63±17.6). There were five males (71.4%) and 2 females (28.6%). Postoperative visual acuity was NLP in seven eyes (87.5%) and LogMAR visual acuity was 0.2 in one eye (12.5%). Visual acuity was related to the patient’s visit time and the visual acuity at visit. Six cases (85.7%) had fever before treatment. Fever was a risk factor for Klebsiella pneumoniae endophthalmitis infection. Eight eyes (100%) had mixed conjunctival congestion, and one eye (12.5%) had abscess in the anterior chamber. Seven eyes (87.5%) underwent vitrectomy combined with intravitreal drug injection, and one eye (12.5%) underwent intravitreal drug injection alone. Infections were controlled in all eight eyes without enucleation. Intraocular pressure was normal during the follow-up period, and there was no infection recurrence. Conclusions: Klebsiella pneumoniae is the main pathogen of endogenous endophthalmitis and is prone to occur in people with diabetes. The onset of the disease progresses rapidly. The early clinical manifestations are not typical, and the prognosis is closely related to the duration of the disease and the timing of treatment. Early treatment can restore some vision.
