白内障超声乳化手术的围术期护理(1)
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[摘要] 目的：分析白内障超声乳化吸除术的要点，总结围术期护理体会。方法：回顾性分析2009年7月～2010年7月于本科行白内障超声乳化手术的98例患者的临床资料，针对手术要点进行围术期护理，包括术前、术中及术后护理，观察术后视力恢复情况及护理满意度。结果：患者手术过程顺利，仅有2例发生角膜内皮轻度损伤，经有效护理愈合良好；患者术后视力均明显提高，裸眼视力术后第1天>0.5者56例(49.1%)，术后1个月>0.5者78例(68.4%)，术后3个月>0.5者100例(87.7%)。结论：围术期护理对提高患者满意度，改善患者视力具有重要的作用。
[关键词] 超声乳化白内障吸除术；护理；围术期；专科护理
[中图分类号] R776.1 [文献标识码]C [文章编号]1674-4721(2011)03(c)-127-02
Perioperafive nursing of phacoemulsification
YU Weihua
(Otolaryngological Department of People′s Hospital in Shizong City of Yunnan Province, Shizong 655700, China)
[Abstract] Objective: To analyze the main points of phacoemulsification and to summarize the nursing experience in perioperative period. Methods: The clinical data of ninty-eight cases of patients with cataract who received phacoemulsification in our department during June 2009 to June 2010 was analyzed retrospectively. According to the operative essentials, nursed during perioperative period including preoperative, operative and postoperative nursing. The return time of vision and nursing effect was observed. Results: The surgery was successful. Only two patients′ corneal endothelium had minor injury, but healed after effective nursing. The postoperative eyesight was improved obviously. Postoperative 1st day the naked vision over 0.5 was 56 cases (49.1%). Postoperative one month the number was 78 cases(68.4%) and postoperative three month the number was 100 cases (87.7%). Conclusion: Perioperafive nursing has important role to improve phacoemulsification effect and ameliorate patients′ eyesight.
[Key words] Phacoemulsification; Nursing; Perioperative period; Specialist care
晶状体像一个透明的双凸透镜，光线透过它在视网膜上汇聚。当晶状体混浊时，就会影响光线的透过折射，成像就会不清楚，这种晶状体的浑浊即白内障[1]。白内障的原因较多，包括老化、遗传、代谢异常、外伤、辐射、中毒和局部营养不良等。超声乳化是在强超声波作用下，在局部产生强烈的局部激波，将晶状体核粉碎，使其呈乳糜状，然后连同皮质一起吸出[2]。本文选择98例白内障超声乳化吸除术患者，回顾性分析围术期护理措施，为改善护理、促进患者康复提供依据。
1 资料与方法
1.1 一般资料
选择2009年7月～2010年7月本科收治的白内障患者98例为研究对象。其中，男48例(56眼)，女50例(58眼)；右眼74例，左眼40例；年龄43～65岁，中位年龄(53.5±4.7)岁；术前视力光感者57眼，指数/眼前者34眼，指数/20～30 cm者12眼，视力0.3以下者11眼。病因：老年性白内障75例，并发性白内障23例。并发症情况：糖尿病31例，高血压27例，呼吸系统疾病22例，心血管疾病18例。在术前对并发症进行治疗，将其控制稳定，不至于影响手术进行[3]。
1.2 手术方法
术前30 min用复方托吡卡胺散瞳，表面麻醉术眼，常规消毒铺巾，棉签蘸碘伏消毒术眼，睑缘消毒注意用0.05%碘伏，避免液体进入结膜囊。粘贴贴巾，上开睑器。用15°穿刺刀作透明角膜隧道切口 ......
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