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Jingdong book

多媒体眼病系列·青光眼：光明的盗贼（附光盘）

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多媒体眼病系列·青光眼：光明的盗贼（附光盘）

Name: 多媒体眼病系列·青光眼：光明的盗贼（附光盘）
Brand: Jingdong book
SKU: 3117125481
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《青光眼——光明的盗贼》一书将青光眼的专业知识以多媒体的方式进行演绎，对原发性青光眼、继发性青光眼、先天性青光眼和混合性青光眼进行了分析介绍，使患者对不同类型的青光眼有一定的认识和了解，同时在青光眼的治疗方面，详细列举了治疗青光眼的药物、各种激光术，及相关的手术术式，从而使患者对选择何种方式进行青光眼治疗有一个完整的概念。

价值和特点:

编者均为国内青光眼科的权威专家
综合讲述了青光眼的分类、易患人群、临床症状及诊断等内容，
对青光眼的各种治疗方式进行了详细讲解，包括药物治疗、激光治疗、手术治疗，同时对青光眼患者的饮食护理和家庭护理也加以阐述
附赠DVD动态视频资料，多媒体结合，力求帮助读者更全面的了解青光眼病的相关知识

Content Description

《青光眼——光明的盗贼》一书以两部分进行讲述，分别为青光眼简介和青光眼治疗，作者根据丰富的临床实践经验，将青光眼的分类、青光眼的易患人群、青光眼的症状、青光眼的诊断进行了详细介绍，同时又深入描述了青光眼不同的治疗方法，包括药物治疗、激光治疗、手术治疗，除此之外，还对青光眼患者的饮食护理和家庭护理进行了进一步阐述，希望能够对青光眼患者提供一定帮助。

Author Description

季健，主任医师，硕士研究生导师，天津医科大学眼科医院青光眼科主任。多年来从事青光眼、白内障的临床及基础研究工作，先后开展了超声乳化白内障摘除术、新式非超声乳化不缝合白内障摘除术、非穿透小梁切除术、经巩膜睫状体光凝、经内窥镜睫状体光凝、房水引流物植入、自体晶状体前囊膜移植治疗青光眼等多项技术。

汪建涛，教授，博士生导师，眼科学博士，留美博士后，天津医科大学眼科医院&眼视光学院副院长，中华医学会眼科学分会青光眼学组委员，天津眼镜学会副理事长，天津细胞生物学会理事，中华眼科杂志编委，上海市浦江人才，上海市和天津市引进人才。

刘伟，眼科学硕士，天津医科大学眼科医院主治医师。毕业后一直从事眼科学的临床、基础研究及教学工作，尤其是在各种类型的青光眼、白内障的诊治方面积累了丰富的经验，对各种遗传性眼病的致病基因定位、产前诊断及出生缺陷干预等工作也具有较深的造诣。

Catalogue

第一章青光眼简介
1.1 青光眼的分类
1.2 哪些人易患青光眼？
1.3 青光眼会有什么症状？
1.4 如何诊断青光眼？

第二章青光眼治疗
2.1 青光眼的药物治疗
2.2 青光眼的激光治疗
2.3 青光眼的手术治疗
2.4 青光眼患者饮食护理
2.5 青光眼患者家庭护理

Book Abstract

第二章青光眼治疗

很不幸，青光眼不能被彻底治愈。所幸的是，一经早期发现，青光眼就可以得到有效的治疗，以延缓青光眼的进展。目前青光眼的治疗主要包括药物治疗、激光治疗、手术治疗三大类。所有的治疗方法都是通过降低眼压以及保护视神经，来阻止或推迟视神经的持续损伤，防止视野的进一步缺损，尽可能长时间地保存现有的视功能。

2.1青光眼的药物治疗

目前，用于降低青光眼患者眼压的药物主要有六大类：

1.前列腺素类（如苏为坦、适利达、卢美根）

本类药物的优点为：降压幅度大；全身副作用小；非眼压依赖，尤适用于低眼压者；适用范围大，适用于开角型青光眼、房角未全部关闭的闭角型青光眼，多种继发性青光眼；使用方便，每日一次，依从性好等。但是本类药物相对较贵，早期局部反应稍重。

2.β-肾上腺素能受体阻滞剂（如噻吗心安、美开朗、贝特舒、贝他根）

本类药物适用于几乎所有类型青光眼，价格也相对便宜；但是其全身副作用较大，哮喘、慢性阻塞性肺疾病、心动过缓，心脏阻滞、充血性心力衰竭、婴幼儿、毒性甲状腺病等患者慎用。

3.肾上腺素能受体激动剂（如阿法根、可乐定）

此类药物全身副作用较小，但是局部刺激症状较重，可透过血–脑屏障导致中枢抑制产生疲乏、无力、嗜睡等症状。

4.碳酸酐酶抑制剂

磺胺类过敏、肾功能不全者慎用此类药物。全身用药（如口服的乙酰唑胺、尼目克司）者不宜长期使用；而局部用药（如派立明）全身副作用小，并且可以增加眼内血流，保护视神经。

5.缩瞳剂（如匹罗卡品、真瑞）

此类药物降压幅度大，起效快，但是副作用较大，不宜长期使用；因其可以破坏血–房水屏障，引起充血、毛细血管通透性增加，不适用于新生血管性、葡萄膜炎性等继发性青光眼。

6.高渗剂（如20%甘露醇、易思清）

此类药物降压幅度最大，适用于急性高眼压，顽固性高眼压者；但其全身副作用大，严重心、肾、肺功能不良，严重脱水，电解质紊乱者禁用。

2.2青光眼的激光治疗（见图11）

激光是当代重大的科技成就之一，激光在医学的应用首先在眼科，应用最多的也是眼科，近20年来，激光在眼科的应用已成为现代眼科领域里的重要组成部分，由于各种更具潜能的新激光光源和设备技术的研制成功，青光眼的各种传统手术均可逐渐为激光治疗所取代。各种类型和各个阶段的青光眼均可采用激光治疗，激光对青光眼的治疗开创了新纪元。

1、激光虹膜周切术

适用于相对瞳孔阻滞而小梁网引流功能正常（房角开放>1/2）闭角型青光眼，为前、后房之间的房水交通造成一个直接通道，解除由于瞳孔阻滞造成的眼压升高和前房角阻塞。

2、激光虹膜成形术

适用于周边虹膜堆积，房角关闭但无顽固性粘连的闭角型青光眼，激光使得虹膜根部收缩，打开或者拉宽房角。

3、激光小梁成形术

通过激光烧灼改善房水的流出易度，适用于多数原发性开角型青光眼患者。

4、激光睫状体光凝术

破坏性手术，通过破坏睫状体的功能，减少房水生成从而达到降低眼压的目的。

2.3青光眼的手术治疗

1、虹膜切除术

通过虹膜周边部切除沟通前后房，使后房房水进入前房，再从开放的前房角引流系统外流，是一种经典和安全的眼内引流术，适用于早期青光眼患者。

2、白内障超声乳化联合人工晶状体植入术

通过摘除白内障，解除瞳孔阻滞，加深前房，加宽房角，促进房水的流出，适用于房角尚未完全粘连的早期青光眼患者。

3、滤过性手术（常规小梁切除、复合小梁切除、非穿透小梁切除术)

通过手术建立房水的外引流通道，适用于大多数各种类型的青光眼患者。

4、引流阀植入术

适用于难治性青光眼，是新生血管性、先天性青光眼的首选。

5、Ex-press青光眼微型引流钉植入术

Ex-press青光眼微型引流钉植入术是一种新型的青光眼外引流手术，引流钉植入物面积小，对眼部肌肉和周围组织影响小，并且具有良好的组织相容性，适合于所有开角型青光眼，Ex-press引流钉降眼压机制基本与传统小梁切除术相同，均是将房水引流至结膜下间隙。

2.4青光眼患者饮食护理

1.注意控制饮水量

一般每次饮水不要超过500mL。因为一次饮水过多，会导致血液高度稀释，血浆渗透压降低，使房水产生相对较多，导致眼压升高。

2.做到“三忌”

即忌烟、忌酒、忌喝浓茶。据研究，过量吸烟，由于烟中尼古丁的作用会引起视网膜血管痉挛，导致视神经缺血，烟草中的氰化物亦可引起中毒性弱视而损害视功能。大量饮酒可造成眼睛充血加重，甚至导致青光眼急性发作。喝浓茶易使人兴奋，引起眼压继发升高。

3.其他注意事项

多进食一些易消化食物，注意饮食卫生，避免肠道传染病，并保持大便通畅。少吃或不吃刺激性食物，如辣椒、生葱、胡椒等。保持精神愉快，避免精神过度紧张而诱发眼压升高。切忌暴饮暴食。

2.5青光眼患者家庭护理

青光眼的治疗固然重要，但家庭护理也不可忽视。若护理不当，可诱发青光眼发作。

1.悦心养性

情绪要稳定，波动不宜过大，保持乐观。平时要心胸豁达，不生闷气，避免无谓的精神紧张，保持愉悦的心情。

2.起居有常

工作学习环境不宜过暗，光线要充足。如果光线不足，会使瞳孔散大，诱发青光眼。工作和学习不能太劳累，不宜过度用眼，避免疲劳，注意劳逸结合，阅读时间不宜超过30~40分钟。定时参加适度的娱乐活动，改善心肺功能，增加眼部血氧供应，减少血中二氧化碳堆积。

3.职业要求

不宜从事夜间工作及美工、纺织化工、国防等辩色要求高的职业。

4.其他禁忌

忌长期低头工作和领口过紧，以减少眼部淤血；忌在黑暗处久留，以避免眼压升高；禁用阿托品、茛菪碱和颠茄等扩瞳药物。

若出现眼胀眼痛、头痛、呕吐、视力骤然下降等情况，即到医院求诊。

……

Introduction

青光眼是当今世界范围内不可逆盲的主要病因，同时也是导致全球视力丧失的第二大病因。青光眼是指眼内压力或间断、或持续升高的一种眼病。持续的高眼压可给眼球各部分组织和视功能带来损害，造成视力下降和视野缩小，如不及时治疗，视野可全部丧失甚至失明。但是很不幸，青光眼不能被彻底治愈。不过，一经早期发现，青光眼可以得到有效的治疗，以延缓青光眼的进展。因此，青光眼的治疗倡导早发现、早诊断、早治疗。本书将在青光眼的分类、青光眼的诊断、青光眼的治疗、青光眼的预防和护理等几个方面为大家详细介绍。

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