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Jingdong book

多媒体眼病系列·冲开障日的环蚀：浅谈眼底黄斑变性（附光盘）

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Jingdong book

多媒体眼病系列·冲开障日的环蚀：浅谈眼底黄斑变性（附光盘）

Name: 多媒体眼病系列·冲开障日的环蚀：浅谈眼底黄斑变性（附光盘）
Brand: Jingdong book
SKU: 3117125521
Price: 26.00 USD
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《冲开障日的环蚀——浅谈眼底黄斑变性》一书，编排合理，重点突出，使患者对年龄相关性黄斑变性的危险因素、临床表现和预防、治疗等内容能够了解得更加详细，同时也能够掌握一些年龄相关性黄斑变性基本的医学知识，从而帮助患者了解具体的情况并提前进行预防或选择适合的治疗方法。

价值和特点：

编者均为国内眼底病与神经眼科的权威专家；将年龄相关性黄斑变性的概念、危险因素、分类、临床表现、诊断、治疗及预防等内容进行了详细阐释；图片均为作者在治疗过程中积累的真实病例图片，图文并茂讲解年龄相关性黄斑变性；附赠DVD动态视频资料，多媒体结合，力求帮助读者选择适合自己的治疗方式。

Content Description

《冲开障日的环蚀——浅谈眼底黄斑变性》一书以两部分进行讲述，分别为年龄相关性黄斑变性概述和年龄相关性黄斑变性防治，作者根据丰富的临床实践经验，分别从什么是相关性黄斑变性、相关性黄斑变性的发病原理、相关性黄斑变性的分类、相关性黄斑变性的治疗方法、相关性黄斑变性最佳的手术时机、相关性黄斑变性术前准备，以及术后的护理等方面加以论述，帮助读者了解相关性黄斑变性的专业知识。

Author Description

李筱荣教授，天津医科大学眼科医院院长，医学博士，玻璃体视网膜病及眼外伤科学科带头人，博士生导师，全国知名眼科专家，中华医学会眼科学分会委员，中华医学会眼科学分会眼底病学组委员，中华眼科杂志、中华眼底病杂志编委。在糖尿病性视网膜病变、黄斑疾病、高度近视性黄斑病变、视网膜脱离及复杂白内障等疾病研究、诊疗方面享有盛誉。承担国家自然科学基金、天津市科委重大课题等多项科研项目。

李志清，副主任医师，擅长黄斑疾病、糖尿病视网膜病变视神经疾病、视网膜脉络膜疾病的诊断和治疗，外眼病尤其泪道疾病的治疗，眼底病的激光治疗（普通激光、PDT、TTT激光）。

Catalogue

第一章年龄相关性黄斑变性（AMD）概述
1.1 年龄相关性黄斑变性概念
1.2 AMD的危险因素
1.3 AMD的分类
1.4 年龄相关性黄斑变性主要临床表现
1.5 AMD的诊断

第二章年龄相关性黄斑变性（AMD）防治
2.1 AMD治疗
2.2 年龄相关性黄斑变性的预防

Book Abstract

第二章年龄相关性黄斑变性（AMD）防治

2.1AMD治疗

2.1.1干性AMD治疗

暂不需要特殊的治疗，需要补充抗氧化维生素和矿物质，并定期随访复诊，以早期发现病变的发展并及时干预。

2.1.2湿性AMD治疗

湿性AMD，一经早期发现，应积极治疗。目前湿性AMD的治疗主要包括药物治疗、激光治疗、眼内注药及手术治疗四大类。

?药物治疗：补充维生素及叶黄素。

?激光治疗：分为热激光光凝、经瞳孔温热疗法（TTT）及光动力疗法（PDT）三种治疗方法。

1）热激光光凝：可直接破坏新生血管复合体，避免渗漏和病灶进一步发展。但是对周围正常视网膜组织产生的不可逆损伤；仅能防止局部的视力轻微减退，82%的患者治疗后视力低于0.1，2年内50%患者CNV复发；其适应证较窄。

2）经瞳孔温热疗法（TTT）：通过长脉冲红外激光的光热效应将热能输送到脉络膜和视网膜色素上皮，直接封闭CNV。与热激光相比，红外激光光组织穿透性强，更易达到脉络膜组织，降低了对视网膜神经上皮的损伤；其温度升高较为温和，可应用于黄斑下CNV。然而，小型试验显示TTT疗效与安慰剂无差异，缺乏多中心、大样本、前瞻性、随机临床研究证据的支持；长期的治疗有效性仍需进一步证实，对黄斑区正常组织仍有一定损害。

3）光动力疗法（PDT）：目前最常用的一种激光治疗方法。开始于2000年,利用光化学效应直接封闭CNV。可以选择性地封闭CNV，不损伤周围正常的视网膜组织和色素上皮细胞，因此可以用于治疗中心凹下典型性为主型CNV。但是大部分患者仍然不断损失视力，提高视力不理想。

?玻璃体腔内注射抗血管内皮生长因子（VEGF）生物抗体

玻璃体腔内注射抗血管内皮生长因子（VEGF）生物抗体的作用原理是通过玻璃体内注射给药，药物直接作用于影响新生血管的关键因子——血管内皮生长因子(VEGF)，从而抑制新生血管，达到治疗效果。与其他治疗方式相比，改善视力疗效明显。缺点是需要多次治疗，存在眼球内注射的潜在风险。

玻璃体内注射治疗（见图20）是经由眼巩膜向眼玻璃体内注入药物的治疗方法。与玻璃体内注射操作有关的不良反应有眼内炎、孔源性视网膜脱离、视网膜撕裂及医源性外伤性白内障等，发生率低，<1%。

玻璃体内注药注意事项有以下几点：

（1）治疗前准备：1）治疗前给予广谱抗生素滴眼液滴眼预防感染，每天4次，连续3天。2）心律不齐、心梗、卒中病史的患者，治疗前需做相应的心脑血管检查，必要时，请专科医师会诊。3）冲洗泪道：确保泪道通畅，无脓性分泌物。4）眼内压（IOP）升高≥30mmHg，需要进行相应的降压治疗，才考虑玻璃体内注射治疗。

（2）注射前消毒、麻醉：术前患眼周围及眼内分别用不同浓度的消毒液擦拭及冲洗消毒，之后用生理盐水冲洗（见图21）。患眼滴入表面麻醉剂，注射时不会有痛感。

（3）术后给予广谱抗生素滴眼液滴眼，并遮盖眼罩（纱布）。治疗后给予广谱抗生素滴眼液滴眼，每天4次，连续3天。避免揉眼：注射1周内，由于存在感染的危险，所以即使出现眼睛不适，也不能用手揉眼。避免碰撞及危险的机械性操作。

（4）极少数患者注射后可能出现以下异常情况：眼部疼痛或不适，眼红加重，对光敏感，飞蚊症（玻璃体漂浮物）及视力下降等。

（5）玻璃体内注射治疗后，术后第一天、3周、6周需要到医院随访。坚持每月随访是治疗成功的关键。

2.2年龄相关性黄斑变性的预防

·戒烟。

·坚持锻炼。

·健康饮食，如增加绿叶蔬菜、鱼类等可降低AMD的发病风险。

·食入大剂量的维生素C、维生素E、β-胡萝卜素和锌补充剂也可大大降低病情进展的风险。

……

Introduction

如果您发现读书看报时一行行字变得歪歪扭扭看不清了，相信多数老年人都会以为是老花眼加重的表现。其实，原因并非那么简单，这很有可能黄斑区出现了问题。一般而言，黄斑疾病在各个年龄段都有可能发生，但老年人发病率则更高。在西方国家，黄斑变性是造成50岁以上人群失明的主要原因，在美国黄斑变性导致的失明比青光眼、白内障和糖尿病性视网膜病变这3种常见病致盲人数总和还要多。在中国黄斑变性发病率有明显的上升趋势。黄斑是我们正常眼睛结构的一部分，是视觉最敏锐的部位，因此黄斑处发生病变对视力影响较大。但幸运的是，我们可以通过很简单的方法自己发现黄斑疾病，一旦出现问题，就可以及时去医院检查并配合积极治疗。我们有越来越多的办法可以治疗黄斑疾病，让您看到清晰美丽的世界，这就是我们出版本书的初衷。

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