不同眼部护理方法对全身麻醉术后患者发生眼部并发症的影响

Effects of Different Ocular Nursing Interventions on Ocular Complications in Patients under General Anesthesia

目的探讨不同眼部护理方法对全身麻醉术后患者发生眼部并发症的影响。方法便利抽样法选取2010年11月至2011年11月在东方肝胆外科医院进行全身麻醉手术的300例患者,按入院先后分为A、B、C、D、E等5个干预组及1个对照组(F组),每组50例。手术开始时在常规保持眼部清洁的基础上,A组患者予以3M透明通气胶布粘贴,B组患者予以生理盐水浸湿的无菌小纱布覆盖,C组患者予以人工泪液滴眼剂滴眼,D组患者予以好视力护眼贴敷贴,E组患者予以红霉素眼膏涂眼后3M透明通气胶带粘贴,F组患者不予任何护理干预。6组患者均于手术结束后3d内进行每日随访,以患者主诉及角膜损伤情况为评价指标,比较各组患者眼睑闭合不全发生率、眼部不适症状发生率、并发症的发生率。结果术中各干预组的眼睑闭合不全发生率均低于对照组,且术后各组患者在眼部刺痛、畏光、异物感方面的差异均有统计学意义(均P<0.05)。E组患者术后效果优于其他干预组。结论对于全身麻醉手术患者,要重视眼部并发症的预防与护理,术中采取红霉素眼膏联合3M透明通气胶带的眼保护方法效果最佳。

Objective To investigate the effects of different ocular nursing interventions on the ocular complications in patients under general anesthesia. Methods From November 2010 to November 2011,300 patients undergoing hepatobiliary surgery under general anesthesia in our hospital,were randomly divided into 5 intervention groups（A.B.C.D.E） and control group（F）（each 50 cases）. On the basis of the routine ocular cleanliness maintenance,the 5 intervention groups were given the corresponding treatments：group A：3M foil tape protection group;group B：saline-soaked sterile gauze protection group;group C：application of artificial tear eye drops~ group D： eye protection group attached;group E： erythromycin and 3M foil tape protection group; control group （F）：no any measure. When the surgeries completed,all the patients were visited once every day in the following 3 days. The patient ~s chief complaint and corneal damage were taken as the evaluation indicators to compare hypophasis incidence, the incidence of ocular discomfort and the incidence of complications. Results The intraoperative hypophasis incidences in the 5 intervention groups were significantly lower than that in the control group （P〈0.05）. The postoperative incidences of ocular irritation photophotia and foreign body sensation showed significant differences between the 5 intervention groups and the control group （P〈0.05）. The postoperative effect in group E was significantly superior to those in other intervention groups. Conclusion The effective ocular nursing and prevention of ocular complications should be taken on patients under general anesthesia. The intraoperative combination of erythromycin eye ointment and 3M transparent ventilation tape works best for ocular prevention.