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Steven Bentman 丁香诊所 马里兰大学医学院附属医院

马里兰大学医学院附属医院视频 / 时长26分钟

丁香诊所全科培训课程 53:青光眼发作处理方法

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课程介绍

在丁香诊所「全科医生强化培训班」中,马里兰大学医学院附属医院医生委员会主席 Steve Bentman 与大家一起讨论青光眼相关话题。

青光眼是一种常见的眼科疾病,根据房水通道阻塞机理的不同分为开角型和闭角型两种类型。眼内压的增高可压迫视神经和视网膜血管,引起视网膜血供减少,神经坏死,最终导致患者视力永久丧失。

青光眼急性发作时,患者患眼剧痛,眼球充血,虹视,角膜混浊,视力骤降或损失,有时伴有恶心呕吐,眼压可高达 30-80 毫米汞柱。其诱因有黑暗环境、散瞳、情绪激动、使用拟交感神经、抗胆碱能和β激动剂等药物。 

患者急性发作时可使用局部滴眼药和全身性脱水药物或通过激光虹膜切开术引流房水来降低眼压。青光眼常用药物包括β阻滞剂倍他洛尔,碳酸苷酶抑制剂乙酰唑胺,α2 激动剂阿伯拉可乐定,局部缩瞳药毛果云香碱和静脉用甘露醇等。

在临床上,突发性失明属于眼科急症之一,但不能因患者症状自行缓解或消失而掉以轻心。视网膜动静脉栓塞也会引起突发性失明。这类患者通常无眼部痛疼,眼底镜检查可见动脉栓塞红点,如静脉阻塞可见水肿和出血点。 

视网膜静脉栓塞常见于青光眼、糖尿病、高血压和高血脂病人。除此之外, 脑部血管瘤也会引起突发性失明,必要时应进行电脑扫描(CT)、磁力共振(MRI)和血管造影等检查。

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Steven Bentman 丁香诊所 马里兰大学医学院附属医院

Steven Bentman,马里兰大学医学院附属医院医生委员会主席。

M.D, University of Maryland Upper Chesapeake Medical Center 500 Upper Chesapeake Drive Belair Maryland

Experience:
June 1998-Present
Emergency Medicine Physician
Medical Director of the Department of Emergency Medicine,(July 2007--Present) Maryland Emergency Medicine Network, University of Maryland.
President of the Medical Staff, (January 2010-January 2014)
Board Member University of Maryland Upper Chesapeake Medical Center (Januaryl/10-1/2014)
Vice President of the Medical Staff, (January2009-- December 2010) Upper Chesapeake Medical Center
Interim Chairman of the Department of Emergency Medicine (December 2006--July2007)
Interim Chairman of the Department of Emergency Medicine (July 2004 -- January 2005)
Member of the Medical Executive Committee(August 2004 -- February 2006), (December2006--Present)
Member of the Performance Improvement Committee(August 2004 -- February 2006), (December 2006--Present)
Member of the STEMI Committee (July 2008 -- Present)
Member of the Stroke Committee (July 2008 -- Present)
Member of the Ethics Committee (July 1998 -- July 2007)
Best Physicians in Baltimore Maryland 2010
Doctor Awards 2005 Best Bedside Manner, Best Communicator
Physician of the Quarter 2001 recognized for service excellence

June 1992-June 1998
Emergency Medicine Physician:
Capital Emergency Associates/EM Care Doctors Hospital
8118 Good luck Road
Lanham, MD 20706

Associate Partner Capital Emergey Associates Education Sel'Vices Coordinator/EMS
Physician Member of the Fast-track Committee Implementation
Physician Member of the Emergey Medicine Department Renovation Committee
Member of Capital Emergency Associates and EM Care Leadership Team
Instructor Nursing Internship Program
Preceptor for the Anne Arundel Hospital Physician Assistant Program
Preceptor for the Essex Community College Physician Assistant Program
Chairman of the Emergency Department Task Force Committee

July 1988- June 1992
Internist
Internal Medicine Physician
White Marsh Medical Center 8817 Bel Air Road
Baltimore MD 21236

July 1985 -- June 1988
Resident Internal Medicine (July 1985- June 1987)
Harrisburg Hospital
South Front Street
Harrisburg PA 17101

Chief Medical Resident (July 1987-- June 1988)
Member of the Special Care Committee (July 1987 -- June 1988)
Member of the Trauma Team

July 1984 - June 1985
Intern Internal Medicine (Julyl984-Junel985)
Lincoln Hospital
234 East 149, Street
Bronx New York

Education
June 1984
Medical Doctor, Universidad Autonoma de Ciudad Juarez Ciudad Juarez, Chihuahua Mexico
June 1979
Bachelor of Science, Long Island University, C. W. Post,Greendale New York
June 1974, High School Diploma, Division Avenue High School, Division Avenue, Levittown New York 11756

Certifications
Board of Internal Medicine, ABIM 1992
Board of Emergency Medicine, BECM 1992
Advanced Cardiac Life-support
Advanced Trauma Life-support
Advanced Pediatric Life-support

Professional Organizaions
Amencan College of Emergency Physicians
Physician Leadershlp Academy Member (Aug. 2003-Present)

Professional Licenses
Pennsylvania
Maryland
Virginia

Hospital Affiliations
University of Maryland Upper Chesapeake Medical Center, 500 Upper Chesapeake Drive, Bel Air, Maryland 21014
University of Maryland Harford Memorial Hospital, 501 South Union Avenue,
Havre de Grace Maryland 21078
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