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颞动脉活检诊断动脉炎性前部缺血性视神经病变合并睫状视网膜动脉阻塞2例

The clinical features of acute Vogt–Koyanagi–Harada syndrome with optic disc edema and serous retinal detachment

ObjectiveTo compare the clinical features of patients with acute Vogt-Koyanagi-Harada syndrome (VKH syndrome) of optic disc swelling (ODS) and serous retinal detachment (RD).MethodsA retrospective clinical study. From January 2013 to November 2019, 212 patients with acute VKH syndrome diagnosed in the Department of Ophthalmology of Shanghai Xuhui District Central Hospital were included in the study. Among them, there were 105 males (210 eyes) and 107 females (214 eyes). The average age was 40.84±13.90 years. All affected eyes were examined by BCVA, FFA, and OCT. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity in statistics. According to the changes in the fundus, the patients were divided into the ODS group and the RD group, 36 patients with 72 eyes (16.98%) and 176 patients with 352 eyes (83.02%), respectively. The independent sample t test was performed to compare the age of onset, visit time and BCVA of the two groups of patients, the χ2 test was performed to compare the count data.ResultsAmong the 72 eyes of 36 patients in the ODS group, there were 16 males with 32 eyes (44.44%), 20 females with 40 eyes (55.56%). The average age was 40.56±16.57 years, the average visit time was 22.47±19.98 days, the average logMAR BCVA was 0.68±0.53. Among the 352 eyes of 176 patients in the RD group, there were 89 male patients with 178 eyes (50.56%), and 87 female patients with 174 eyes (49.43%). The average age was 40.90±13.34 years, the average visit time was 17.25±24.40 days, the average logMAR BCVA was 0.80±0.56. The average age (t=－0.116), gender composition ratio (χ2=0.448), average visit time (t=1.204), average logMAR BCVA (t=－1.661) comparisons between the two groups showed no statistically significant differences (P＞0.05). There was no statistically significant difference in the average logMAR BCVA between the RD group and the ODS group of different eyes (t=0.227, 0.810; P＞0.05). There were 50 (69.44%, 50/72) and 272 (77.27%, 272/352) eyes in the ODS group and RD group with inflammation of the anterior segment. There were anterior segment reactions between the two groups. There was no statistically significant difference in the number of eyes (χ2=1.003, P＞0.05). There were 34 (19.32%, 34/176) and 2 (5.56%, 2/36) patients with headache and hearing loss, respectively. The comparison of the number of patients with headache and hearing loss between the two groups showed statistically significant differences (χ2=4.015, P＜0.05).ConclusionCompared the patients with ODS acute VKH syndrome, the patients with serous RD acute VKH syndrome are more likely to have extraocular symptoms such as headache and hearing loss.

下腹部横切口分层撕开法在妇产科手术中的应用

【摘要】 目的 观察下腹横切口分层撕开法在妇产科手术中的临床效果。 方法 所有2009年4-11月在我院行妇产科手术的382例患者，采用下腹横切口分层撕开法，用可吸收线分层缝合，皮肤内潜行缝合法。 结果 所有患者均获甲级愈合，无1例出现腹部切口感染，仅3例剖宫产发生脂肪液化，无1例胎头取出困难，均能完整切除较大子宫肌瘤。 结论 下腹横切口分层撕开法具有开腹时间短、住院时间短、医疗费用低、无需拆线、刀口愈合后瘢痕松软等优点，顺应了美容的潮流，具有临床推广应用价值。