【摘要】 目的 探討機械法準分子激光角膜上皮瓣下磨鑲術（Epi-LASIK）對大視杯高度近視患者的視網膜神經纖維層 （RNFL）的影響。 方法 對2007年1月-2009年1月擬行Epi-LASIK手術的眼底杯盤比gt;0.5的44例44只眼行光相干斷層掃描（OCT）檢查，測量以視盤為中心、直徑為3.4 mm的RNFL厚度， 以象限圖分4個區域（上方、下方、顳側、鼻側）顯示。并分別于手術前及手術后第10 天，1、3 個月，1、2年進行隨訪。對所測數據進行方差分析。 結果 RNFL厚度測量結果顯示， 手術前上方、下方、鼻側、顳側RNFL厚度與手術后比較， 差異均無統計學意義（Pgt;0.05）。 結論 Epi-LASIK手術對大視杯近視的RNFL厚度無明顯影響。【Abstract】 Objective To investigate the effects of Epi-LASIK on retinal nerve fiber layer (RNFL) thickness in patients with large cup. Methods Forty-four patients (44 eyes) with high myopia from January 2007 to January 2009, whose C /D area ratios were above 0.5, underwent optical coherence tomography(OCT)examination. To measure the RNFL thickness taking optic disk as the center, diameter as 3.4 mm, for quadrant graph as above, below, temporal, lateral. After the operation in the first 10 days, and one, three months, and one, two years after surgery were followed. The data were analyzed by analysis of variance. Results The RNFL thickness at every quadrant had no statistical significant difference between preoperative period and postoperative time(Pgt;0.05). Conclusion Epi-LASIK surgery has no effect on RNFL thickness in high myopic patients with large cup.
Objective To evaluate the effects of peripheral venous remaining needle sealing with heparin vs. saline in China. Methods A comprehensive, systematic bibliographic search of medical literature from databases of CNKI (1994 to December, 2009) and Wanfang (1990 to December, 2009) was conducted to identify randomized controlled trials (RCTs) related to catheter sealing with saline vs. heparin. The remaining time of venous needle, the incidence of phlebitis and the catheter blockage were compared, and the quality of RCTs was assessed and meta-analyses were conducted by RevMan 5.0 software. Results Nine RCTs involving 1 770 patients were included. The results of meta-analyses showed that: a) There was a significant difference between heparin sealing and saline sealing in catheter blockage (OR=0.44, 95%CI 0.32 to 0.62, Plt;0.05). The heparin sealing was much better to prevent catheter blockage; b) There was no significant difference between saline sealing and heparin sealing in the incidence of phlebitis (OR=1.26, 95%CI 0.64 to 2.50, Pgt;0.05); and c) The average remaining time of venous catheter between saline sealing and heparin sealing had significant difference (WMD=0.24, 95%CI 0.04 to 0.43, Plt;0.05). Heparin sealing had better effect than saline sealing. Conclusion The meta-analyses of current medical literature in China show that heparin sealing can reduce the incidence of catheter blockage and prolong the remaining time of catheter, although there is no significant effect in the aspect of the incidence of phlebitis.