近视激光手术患者的健康教育管理

Individualized Health Counseling for Myopia Patients Undergoing Laser Correction Surgery

目的探讨全程个性化健康教育管理对近视激光手术治疗患者疗效与安全性的影响。方法 2005年至2008年1173人(2287眼)接受了Q-值调整的个性化准分子激光原位角膜磨镶术(F-CAT),566例(1104眼)接受一般教育为对照组,607例(1183眼)接受过全程个性化健康教育为研究组,内容包括个性化LASIK手术知识讲解、心理疏导、护理知识和术后注意事项宣教。结果个性化健康教育后明显减少患者术前精神紧张程度,使更多的患者能接受手术治疗,术中配合更好。研究组术后3个月、6个月的随访率分别为95.7%、84.3%,明显高于对照组(85.9%、70.1%)。研究组术后1个月内遵医用药比例明显高于对照组(98.8%vs 94.9%,P<0.01),研究组术后1个月、3个月遵医用眼比例分别为97.2%、94.5%,明显高于对照组(92.7%、89.7%)。所有患者术后1个月、3个月和6个月时的屈光度均较术前明显改善,裸眼视力≥1.0的比例以研究组稍高,但与对照组比较并无明显差异。研究组患者术后对视力改善程度感到非常满意和较满意的比例明显高于对照组(97.7%vs 95.3%,P<0.05),研究组并发症发生率均低于对照组。结论全程个性化健康教育管理有利于提高近视患者激光手术治疗的安全性与视觉满意度。

Objectives To investigate the effect of individualized health counseling on the efficacy and safety of laser correction surgery in myopia patients.Methods One thousand two hundreds and eighty-seven myopia patients（2287 eyes） underwent laser correction surgery with German Wavelight Allegretto wave Eye-Q bye means of F-CAT.,which were divided in to control group（566 patients,1104 eyes,counseled with basic surgery knowledge and selfeducated at home） and intervention group（607 patients,1183 eyes,individually counseled through one to one interview,psychological intervention and telephone visit）.Results Of the intervention group,the patients were of less anxiety and more of them signed the consent of surgery and cooperated better.The 3,6 moth post-operative visit rates were significantly higher in intervention group（95.7%,84.3%） than in control group（85.9%,70.1%）.The postoperative medication adherence rates within 1 month and at 1,3 month were also significantly higher in intervention group（98.8%,97.2%,94.5%） than in control group（94.9%、92.7%、89.7%）.The diopter at 1,3 and 6 month was markedly improved in all patients.The ratio of patients with naked visual acuity above 1.0 was higher in intervention group than in control group,however,without significance.The extreme satisfaction and satisfaction rate was higher in intervention group compared with control（97.7% vs.95.3%,P0.05）.Conclusions individualized health counseling improves the safety and patient satisfaction in laser correction surgery