复合式小梁切除术的护理体会

The nursing of compound trabeculectomy

目的:探讨联合应用抗代谢药物5-氟尿嘧啶(5-FU)和巩膜瓣可调节缝线的复合式小梁切除术的术前、术后护理方法及其效果。方法:通过对58例70眼的复合式小梁切除术患者,术前做好心理护理,加强全身护理与眼部护理,控制眼压,眼部清洁消毒。术后观察术眼视力、眼压、滤过泡、角膜、前房情况,局部用药与眼球按摩以促进功能性滤过泡的形成,有效控制眼压。出院指导与随访给患者提供健康教育。结果:本组58例70眼经有效的护理,均顺利实施手术,术中、术后无严重而持久的并发症,术后恢复理想,平均随访23个月,64眼维持功能性滤过泡,占91.43%,62眼眼压<21mmHg,眼压控制有效率为88.57%,大部分患者能坚持较长期的随访复查。结论:对复合式小梁切除术患者进行积极的心理护理与青光眼相关的健康知识教育,为手术的顺利实施和术后康复提供了保障。

Objective：To discuss the mursing methods and its effects for compound trabeculectomy with 5 -floxuridine and adjusted suture of scleral flap. Methods：The compound trabeculectomy was performed on 58 cases （70 eyes） ,to make they well known of their disease and dispel their bad mood through well psychogenic nuring. Before operation, to enhance general and ocular nursing, reduce lOP （intraocular pressure） to normal,clean and disinfect the eyes. Mter operation,observe the visual acuity,IOP,fihering bleb,cornea and anterior chamber. To promote the formation of functional filtering bleb through local medication and ocular massage, control IOP effectively. Provide healthy education through discharge guide and follow - up. Results：The all operations were perfectly performed under effective nursing. There was no serious complications during and after operation. All patients recovered favoring. The mean follow - up was 23months. 64 eyes maintain functional filtering bleb（91.43% ）, The IOP of 62 eyes was lower than 21 mmHg. The effective rate of IOP control was 88.57%. Most patients can insist on perennial follow - up and reexamination. Conclusion：The effective psychogenic nursing and healthy education can provide psychology, conciliation and encouragement for patients of compound trabeculectomy, which also lead them gain healthy knowledge about glaucoma. The effective clinic therapeutic nursing give guarantee to the favoring operation and healing.