目的:探讨强化二级预防管理对糖尿病视网膜病变患者遵医行为及预后的影响.方法:选取2019年1—12月到高明区人民医院就诊的糖尿病视网膜病变患者184例作为研究对象,按糖尿病视网膜病变分级分为强化管理组和一般管理组,每组各92例.一般管理组采用常规医院延续管理,强化管理组建立多学科协作三位一体的联动团队进行强化二级预防管理.干预随访2年后,比较两组患者的糖化血红蛋白、空腹血糖、餐后2 h血糖、生活质量、治疗及护理满意度、糖尿病相关年平均住院率、疾病相关知识掌握程度、治疗依从性、糖尿病视网膜病变分级各项指标有

目的:探讨荧光素钠眼底造影在老年糖尿病视网膜病变中的应用.方法:研究对象选择我院收治的120例2型糖尿病初诊患者,选择时间2021年1月-2021年6月,120例患者分别采用检眼镜检查以及荧光素钠眼底造影检查,分析荧光素钠眼底造影的表现特征,对比两种检查方法的差异性.结果:120例患者中70例为糖尿病视网膜病变,经过检眼镜检查50例患者为糖尿病视网膜病变,检出率为71.43％,经过荧光素钠眼底造影检查60例患者为糖尿病视网膜病变,检出率为85.71％,组间数据对比具有统计学意义(P ＜ 0.05),同时荧

目的 探讨白内障人工晶体(intraocular lens,IOL)植入术前术后前房深度(anterior chamber depth,ACD)的变化对术后屈光状态的影响,使植入的人工晶体度数准确.方法 随机选取2018年1月—2019年12月在医院常规行白内障手术并植入人工晶体患者500例,随机分为对照组和试验组;对照组用厂家提供的人工晶体常数计算白内障植入人工晶体度数,通过矫正度数预测误差再计算得出优化常数;试验组使用经过前房改变后优化的人工晶体常数并计算白内障术后矫正度数的预测误差,计算术前预测屈光值与术后实际屈光值差.分析两组患者术前术后前房的变化情况及术后屈光状态.结果 两组患者术前前房深度对比差异无统计学意义(P>0.05);但两组患者手术后前房深度明显高于术前,对比差异有统计学意义(P<0.05).试验组患者术后屈光完全矫正值为(0.93±0.21)D,对照组患者术后屈光完全矫正值为(0.83±0.19)D,对比差异有统计学意义(t=5.583,P=0.000).结论 使用通过前房深度改变得到的优化常数并计算白内障植入的人工晶体屈光度,对患者术后恢复正常视力有一定的提高.

AIM:To observe and analyze the effect of non-mydriatic fundus photography in screening diabetic retinopathy(DR), so as to provide the basis for clinical screening.METHODS:In our hospital from December 2016 to November 2017, 120 patients(240 eyes)was diagnosed as diabetes(DM), which were treated as the subjects of observation. By the same operator with non-mydriatic fundus photography, fundus photography and 7 range fundus fluorescein angiography(FFA)after mydriasis were taken. Taking the international clinical classification of diabetic retinopathy(DR)as the standard, the above three examinations were review, grade and record by the same physician by blind method. The fundus fluorescein angiography as the gold standard, the other two results were compared to detect the sensitivity, specificity, Youden index, Kappa value of the two for DR with different grade.RESULTS: There was 70.0% eyes diagnosed as diabetic retinopathy after screened by fundus angiography, 66.7% by post-mydriatic fundus photography, 65.0% by non-mydriatic fundus photography. The grading results of diabetic retinopathy screened by different methods were basically consistent, with no significant difference(P>0.05). When screening for diabetic retinopathy of different degrees, the sensitivity and specificity of the non-mydriatic group were 92.9% and 90.3%, respectively. There was no significant difference between the results of the non-mydriatic group and the non-mydriatic group. Compared with the gold standard group(FFA), the Youden index(83.14%)was close to 1, with high reliability; Kappa=0.81, and the validation was consistent. When screening for moderately nonproliferative diabetic retinopathy, the sensitivity and specificity of non-mydriatic fundus photography were 90.6% and 95.5%; there was no significant difference between the results of non-mydriatic and the results of fundus photography after mydriasis. Compared to the gold standard group, the Youden index was 86.09%, the reliability is high, Kappa=0.86, and the test was consistency. CONCLUSION:Non-mydriatic fundus photography can be used as a simple and accurate method for screening diabetic retinopathy. It is simple and easy to carry out without risk. It is easy to train specialist technicians for multi-point operation. With the help of today's convenient network, the image is transmitted to an experienced ophthalmologist for reading and diagnosis, which is convenient and fast, so that the patient can be diagnosed and treated nearby, which has positive significance for the society.

目的 对比免散瞳眼底照相与散瞳后7方位眼底照相两种筛查方法 在糖尿病视网膜病变(DR)诊断中的应用价值.方法 选取120例(240眼)糖尿病并到眼科进行DR筛查的患者作为研究对象,均行免散瞳眼底照相、散瞳后7方位眼底照相及眼底荧光血管造影检查,以眼底荧光血管造影检查作为"金标准",对比两种筛查方法 诊断DR的敏感性、特异性及准确度.结果 免散瞳眼底照相诊断DR患者109眼,诊断符合率为96.25%(231/240),散瞳后7方位眼底照相诊断DR患者110眼,诊断符合率为98.33%(236/240),两种筛查方法 比较差异无统计学意义(χ2=1.977,P=0.130>0.05).免散瞳眼底照相对DR的诊断敏感性、特异性分别为94.64%(106/112)、97.66%(125/128);散瞳后7方位眼底照相的诊断敏感性、特异性分别为97.32%(109/112)、99.22%(127/128).两种筛查方法 诊断敏感性、特异性比较差异无统计学意义(χ2=1.042、1.016,P=0.249、0.311>0.05).结论 免散瞳眼底照相操作简便、诊断效能较高,是最佳的筛查DR的方法 .

目的 探究免散瞳眼底照相筛查不同分期糖尿病视网膜病变的临床意义.方法 150例(300只眼)2型糖尿病患者进行临床探究,对患者行免散瞳彩色数码眼底照相技术筛查,根据患者的不同糖尿病视网膜病变情况进行分期,按照病程情况分类统计患者的发病率;对于糖尿病视网膜病达到Ⅲ期及以上的患者行荧光素眼底血管造影术(FFA)检查,比较分析2种不同检查方式的有效情况.结果 150例(300只眼)2型糖尿病患者进行免散瞳眼底检查,检查结果显示患有不同程度视网膜病变的占31.67%(95/300).病程<1、1~、5~、10~、>20年糖尿病视网膜病变检出率分别为14.58%、17.31%、25.00%、42.16%、48.00%.免散瞳眼底照相检查和FFA检查的诊断一致性较高(P<0.05).结论 本次研究证明在进行糖尿病视网膜病变诊断筛查过程中,可以使用免散瞳眼底照相进行筛查,检测效果与FFA效果一致性较高,且操作简便,进一步为糖尿病视网膜病变的诊断与治疗提供了评价标准.

Objective:To explore the emmetropia intervention on the prevention and treatment of the myopia in early days.Methods: 200 cases of visual acuity above 1.0,refraction at 0~+0.75 D,the age at 4~7 year old,were divided into control and intervention group,each 100 cases.The control had never given any processing,the intervention was given Atropine sulfate eye ointment/week or given the Tropicamide eye drops to sleep before drop an eye/day,reexamine visual acuity and refraction annually,continuously for 5 years.The difference of group was tested with four space watch card square examination.Results: With the Visual acuity decreased below 1.0,the control group was 47 people,account for 47.5%,the intervention group was 21 people,account for 21.4%.The control group showed the specific value higher(χ2=14.78,P0.01).The refraction decreased below-0.25 D,the control group was 49 people,account for 49.5%,the intervention group was 24 people,account for 24.5%.The control group showed specific value higher(χ2=13.2,P0.01).Conclusion: It has the clinical meaning to start the intervention of the emmetropia in early days.