Реферат
Objective To explore the clinical effect of amniotic membrane transplantation combined with entropion correction for ocular surface and eyelid burns.Methods A total of 80 patients with ocular surface injury and lower eyelid entropion caused by chemical or thermal burns who received surgical treatment in our hospital were selected as the research objects.All patients received amniotic membrane transplantation combined with entropion correction.All patients were examined by slit-lamp microscope and photographed before and 8 weeks after surgery.The visual acuity changes,tear film rupture time and serum levels of vascular endothelial growth factor(VEGF),trans-forming growth factor β1(TGF-β1)and insulin growth factor 1(IGF-1)were compared before and 8 weeks after surgery.Eight weeks after surgery,exfoliated epithelial cells of the central cornea and limbus were collected and analyzed by PAS staining and immunofluorescence staining.Results At 8 weeks after surgery,the patient's ocular surface condition recovered well,eyelid entropion was successfully corrected,postoperative visual acuity was significantly better than that before surgery(P<0.05).Compared with before surgery,the tear film rupture time 8 weeks after surgery was significantly prolonged(P<0.05),and the serum VEGF,TGF-β1 and IGF-1 levels 8 weeks after surgery were significantly increased(P<0.05).PAS staining showed that there was no goblet cell in the central cornea and limbus.Immunofluorescence staining showed that cytokeratin 12(CK12)was highly expressed in the corneal epithelial cells,and low expressed in corneal limbal epithelial cells near the cornea.Conclusion Amniotic membrane transplantation combined with entropion correction has a significant therapeutic effect on patients with ocular burn,which can promote ocular surface repair,correct entropion,improve postoperative visual acuity,and achieve self-amplification of cornea stem cells.It is a safe and effective treatment method.
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Objective To understand the occurrence of surgical site infection(SSI)following caesarean section,analyze risk factors,implement intervention measures,and evaluate intervention efficacy. Methods All puerperas who underwent caesarean section in the obstetric department of a hospital from January to December 2013 were mo-nitored,investigation were performed in two stages:evaluation stage(January-June,2013)and intervention stage (July-December,2013). Targeted intervention and clinical intervention were combined to intervene the risk factors. Occurrence of SSI,length of hospital stay,and hospitalization expense before and after intervention were compared. Results A total of 1 593 patients with caesarean section were monitored,31(1.95%)had SSI,incidence of SSI in evaluation stage and intervention stage were 3.40% and 0.95% respectively;incidence of SSI before and after inter-vention was significantly different(χ2= 12.02,P<0.01). Univariate analysis on evaluation stage showed that risk factors for SSI in patients with caesarean section were duration of operation≥1 hour,body mass index≥26 kg/m2,intraoperative blood loss ≥300 mL,underlying diseases,premature rupture of membranes,and without antimicro-bial prophylaxis(all P<0.05). In evaluation stage,648 patients received post-operative antimicrobial prophylaxis for>48 hours(n= 395,60.96%);in intervention stage,945 patients received post-operative antimicrobial prophy-laxis for<24 hours(n= 776,82.12%),different time distribution of post-operative antimicrobial prophylaxis in two stages after intervention was compared,difference was statistically significant(χ2= 673.26,P<0.01). The mean length of hospital stay of 31 SSI patients were(13.83±3.26)days,non-SSI patients were(7.06±1.66) days,difference was statistically significant(t= 7.86,P<0.01);the average hospitalization expenses for patients with SSI were(9 044.77±2 649.19)yuan,non-SSI patients were(6 254.73±638.52)yuan,difference was statis-tically significant(t= 4.344,P<0.01).Conclusion Intervention measures for risk factors of SSI after caesarean section can effectively reduce the incidence of SSI in caesarean section.