曲安奈德治疗黄斑水肿的疗效观察与护理

Observation on curative effect of triamcinolone acetonide to treat patients with macular edema and nursing care of them

[目的]观察玻璃体腔注射曲安奈德对黄斑水肿的疗效观察及围术期的护理。[方法]对69例75眼黄斑水肿病人,给予玻璃体腔注射曲安奈得4mg,观察注药前后视力的变化、黄斑水肿的消退情况以及并发症的出现情况。[结果]注药前的平均视力为0.16±0.14,注药后平均视力为0.47±0.33,其中最佳矫正视力达1.0,视力提高3行及以上者58眼,占77.3%;不变者17眼,占22.7%。与治疗前比较,差异有统计学意义(t=-7.596,P<0.01)。注药前OCT测量黄斑的厚度为429.9μm±125.3μm,随访结束时黄斑厚度为186.1μm±42.5μm,与治疗前比较,差异有统计学意义(t=15.953,P<0.01)。治疗后眼压增高者12例,占17.4%,眼压为29mmHg～37mmHg。1例无晶体眼曲安奈德颗粒进入前房出现假性眼内炎,等发生。[结论]玻璃体腔注射曲安奈德能有效地治疗黄斑水肿,完善的围术期护理能有效的防止注射并发症的发生。

Objective： To observe the curative effect of macular edema patients treated with triamcinolone acetonide injecting in vitreous cavity and peri -operative nursing care of them. Methods：A total of 75 eyes of 69 patients with macular edema were treated with injecting triamcinolone acetonide 4mg in vitreous cavi- ty, then the change of vision, regression of macular edema and complications were observed before and after injecting of triamcinolone acetonide. Results： The average Visions of all patients were 0.16 ± 0.14 and 0.47 ± 0.33 before and after injecting triamcinolone acetonide respectively. The best corrected vision among them was 1.0. Visions of 58 eyes improved three lines or rmre amounted for 77.3 %. However, visions of 17 eyes were not changed, which accounted for 22.7%. There was statistical significance in terms of vision change between before and after treatment （ t = - 7. 596, P 〈 0.01 ）, The average thickness of macula flava of all cases was 429.9 μm ± 125.3 〉m before injecting triamcinolone acetonide and 186.1μm ± 42.5μm after follow - up completed. There was statistic significant differences between them （ t = 15. 953, P 〈 0.01 ）. After treatment, 12 cases developed increased intraocular tension which accounted for 17.4 % with the intraocular tension of 29 mmHg-37 mmHg. A case developed false endophthalmitis due to aphakia and triamcinolone acetonide particle injected into anterior chamber. Conclusion：Triamcinolone acetonide injection in vitreous cavity can effectively treat patients with macular edema. And consummate perioperative nursing care for patients can effectively prevent complications of injection from hap pening.