玻璃体腔内注射曲安奈德治疗黄斑水肿术后高眼压的的护理

黄斑水肿常因视网膜中央静脉阻塞、糖尿病视网膜病变、内眼手术等原因引起[1].

玻璃体腔注射曲安奈德治疗糖尿病黄斑囊样水肿的护理

黄斑区弥漫性水肿是导致糖尿病视网膜病变病人视力严重下降的主要原因,目前常用的治疗方法为激光格栅样光凝及药物保守治疗,但效果都不理想[1].曲安奈德是一种长效糖皮质激素,玻璃体腔注射具有很强的抗炎作用,能有效地改善黄斑水肿[2,3].我科采用此方法治疗22例(25眼)弥漫性黄斑水肿病人,效果较满意.现将护理报告如下.

曲安缩松在整形美容外科应用中的副作用分析

用曲安缩松悬浊液局部封闭治疗瘢痕及瘢痕疙瘩等疾病,起效快,疗效稳定,因而在烧伤、整形及美容患者中广泛应用.笔者从1992年8月用曲安缩松(意大利黑沙化马大药厂生产)局部封闭治疗上述疾病588例,出现比较明显的不良反应24例,现总结如下.

两种糖皮质激素注射液皮损内注射治疗活动期斑秃的临床疗效观察

目的 比较复方倍他米松注射液和醋酸曲安奈德注射液皮损内注射治疗活动期斑秃的临床疗效.方法 将160例活动期斑秃患者随机分成两组,治疗组100例、对照组60例,治疗组用复方倍他米松注射液皮损内注射,对照组用醋酸曲安奈德注射液皮损内注射,每3周1次,12周后观察结果.结果 治疗12周后治疗组痊愈60例(60.0%),显效32例(32.0%),总有效率92.0%;对照组痊愈25例(41.7%),显效19例(31.67%),总有效率73.3%;治疗组有效率和痊愈率显著高于对照组(χ2值分别为10.25和5.06,P<0.01和<0.05).治疗组出现局部头皮萎缩8例(8%),局部毛囊炎8例(8%);对照组出现局部头皮萎缩9例(15%),局部毛囊炎3例(5%),两组不良反应发生率比较,差异无统计学意义(P>0.05).结论 复方倍他米松注射液皮损内注射治疗活动期斑秃疗效显著.

Purpose: To evaluate the clinical effect of 5-μm pore filter connected with three-way cock by removing the vehicle in triamcinolone acetonide (TA) suspension.Methods: Through 5-μm pore filter connected with three-way cock, TA suspension was replaced by intraocular irrigating solution. The new suspension has been applied to 60 cases of diabetic branch retinal vein occlusion, diabetic macular edema and agerelated macular degeneration patients through intravitreal injection. It was also been applied to 41 cases of diabetic retinopathy, epimacular membrane, proliferative vitreoretinopathy and idiopathic macular hole patients to assist pas plana vitrectomy (PPV). Whether TA particles can adhere to posterior hyaloid cortex, epiretinal membrane and internal limiting membrane during the surgery have been observed.During follow up, corrected visual acuity and intraocular pressure were recorded.Results: Fiveμm pore filter connected with three-way cock can remove the vehicle in TA suspension successfully and retain TA particles. When the new suspension was applied to assist PPV, it can adhere to posterior hyaloid cortex, epiretinal membrane, internal limiting membrane and visualized them clearly. In all the 41 cases that underwent PPV surgery, visual acuity of 30 cases increased or remained stable.Intraocular hypertension happened in 4 cases. Two cases of the 41 patients had cataract formation during follow up. In the 60 cases that underwent TA intravitreal injection,45 cases increased their visual acuity at least 2 lines. Intraocular hypertension happened in 17 cases and 4 patients had cataract formation. None of the 101 patients caught endophthalmitis or other serious complications.Conclusion: Filter connected with three-way cock can remove the vehicle in TA suspension effectively and this procedure can be applied to intravitreal injection or PPV. This manipulation is so simple that it deserves to be popularized for clinical use.

Purpose:To study the effect of intravitreal injections of triamcinolone acetonide (TA) for the treatment of macular edema secondary to central retinal vein occlusion (CRVO)in a sample of Chinese patients from Shaanxi province.Methods:The 50 eyes from 50 patients were separated into three TA treatment groups:17 patients were given 4 mg/0.1ml,19 patients were given 8 mg/0.2 ml,and 14 patients were given 16 mg/0.4 ml.Patients were followed up for 12 months.Foveal thickness,intraocular pressure (IOP),and best-corrected visual acuity (BCVA) were measured.Results:Macular edema responded well both anatomically and functionally to the TA injections.After the initial intravitreal injection,macular edema recurred at 2-4 months in the low-dose group (4 mg),at 3-5 months in the medium-dose group (8 mg),and at 6-9 months in the high-dose group (16 mg).No significant difference in BCVA or in foveal thickness were observed between the first intravitreal injection and the re-injection.There was no increase in IOP after re-injection of 16 mg TA,if the patient did not have an elevated IOP after the initial intravitreal injection of 4/8 mg TA.Conclusion:A low dosage of TA (4 mg) administered via intravitreal injection might be useful as an initial treatment for macular edema secondary to CRVO.A higher dosage of TA (16mg) can be used if there is no IOP elevation with the initial TA injection.