国际医师会诊网络系统在眼病诊断及治疗中的应用  

Application and clinical significance of International Physician Referral Network in diagnosing and treating ocular diseases

作　　者：赵宏[1] 王瑞峰[1] 李彩红[1] 周芳[1] 赵晓金[1] 田思佳[1] 

机构地区：[1]郑州市第二人民医院眼科,450006

出　　处：《中华眼外伤职业眼病杂志》2016年第3期184-187,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技惠民计划项目（142207310002）;郑州市科技惠民计划项目（141pkjhm468）

摘　　要：目的探讨国际医师会诊网络系统（Internet Physician Referral Network）在眼病诊断及治疗中的应用和临床意义。方法2014年3月至2015年9月在我院进行国际医师会诊的病例318例纳入本研究。将其详细的病例资料以英文通过互联网传送至美国堪萨斯州眼底病防治中心进行分析并提出诊断治疗意见和手术方式。结果进行国际会诊的318例中，增生性糖尿病视网膜病变48例、年龄相关性黄斑变性42例、难治性青光眼39例、家族性渗出性玻璃体视网膜病变35例、全葡萄膜炎22例、视神经视网膜病变20例、外层渗出性视网膜病变19例、视网膜静脉阻塞15例、高度近视脉络膜视网膜病变15例、巨细胞病毒性视网膜炎14例、先天性脉络膜缺损13例、视网膜劈裂11例、视网膜中央动脉阻塞8例、视网膜囊尾蚴病5例、急性一过性白点综合征3例、脉络膜黑素瘤3例、视网膜蔓状血管瘤2例，视网膜巨大动脉瘤2例，弥漫性脉络膜萎缩l例，视盘色素细胞瘤l例。对反馈的318例病历资料进行分析，与我院诊断一致者为292例（91．82％）。其中42例糖尿病视网膜病变患者、5例视网膜猪囊尾蚴以及4例巨细胞病毒视网膜炎引起的视网膜脱离诊断确定后施行了25G玻璃体切除术，12例年龄相关性黄斑变性做了眼内注射雷珠单抗，难治性青光眼施行了引流阀植入术，其他眼病的治疗建议除特殊药物我院尚不具备外均被我院采纳。结论国际会诊和国际医疗资源的合作开辟了我国一个新的医疗诊断模式，值得进一步探索和不断完善。Objective To discuss clinical application and significance of International Physician Referral Network（IPRN） in diagnosing and treating ocular diseases. Methods A total of 318 cases from March 2014 to September 2015 were enrolled in this study. All detailed data were transmitted to the center for Fundus Diseases Control and Prevention in Kansas for discussion about the diagnosis and the opinion of treatment and surgery. Results Among the 318 cases, there were 48 cases of＂ proliferative diabetic retinopathy, 42 cases of age related macular degeneration, 39 cases of refracto~ glaucoma, 35 cases of familial exudative vitreoretionpathy, 22 cases of panuveitis, 20 cases of optic neuroretinopathy, 19 cases of external exudative retinopathy, 15 cases of retinal vein occlusion, 15 cases of retinopathy in high myopic eyes, 14 cases of cytomegalovirus retinitis, 13 cases of congenital coloboma of choroid, 11 cases of retinoschisis, 8 cases of central retinal arteral occlusion, 5 cases of retinal eysticercosis, 3 cases of acute evanescent white dots syndrome, 3 cases of melanoma of choroid, 2 cases of retinal racemose angionla, 2 cases of retinal macroaneurysm, 1 case of diffuse choroid atrophy, and 1 case of melanocytoma of the optic disc. The feedback diagnosis was identical with that of us in 292 cases, the corresponding rate of diagnosis was 91.82% （292/318 ）. The 25 G vitrectomy was performed in 42 patients with diabetic retinopathy, 5 patients with retinal cysticereosis, and 4 patients with retinal detachment caused by eytomegalovirus retinitis. 12 patients with age related maeular degeneration reeeived intravitreal ranibizumab, patients with refractory glaucoma had glaucoma filtration device implantation. All the proposed treatment methods, except some very special drugs therapy, were adopted by our hospital. Conclusion A new work mode of medical diagnosis is started by telemedicine consultation and cooperation over international medical resources in China, which deserves further exploration and enhancement

关 键 词：国际医师会诊网络系统 互联网 疑难眼病 

分 类 号：R77[医药卫生—眼科]