抗血管内皮生长因子药物玻璃体腔注射的围手术期护理

Perioperative nursing care in the intravitreal injection of anti-vascular endothelial growth factor a- gent

目的探讨抗血管内皮生长因子（anti—vascularendothelialgrowthfactor，anti—VEGF）药物玻璃体腔注射围手术期的护理问题及护理对策。方法总结anti—VEGF玻璃体腔注射围手术期不同阶段的护理职责，观察2012年4月至2012年9月在我院确诊的218例（305眼）眼内新生血管和黄斑渗出性病变患者anti-VEGF玻璃体腔注射的术后并发症、依从性和术后复诊情况。结果通过在围手术期护理过程中加强集中宣教、患者信息核对、药物管理、无菌操作、并发症密切观察等环节，患者表现出较好的依从性，复诊率97．4％，257眼（84．3％）在观察期内完成了3～5次注射。注射后容易出现一过性眼压升高，并可以在短期内恢复正常或经治疗后控制。随访期间未发现眼内炎、视网膜脱离、晶状体损伤或玻璃体积血等并发症。结论优质的护理配合，有助于提高患者的依从性和保障医疗安全，进而促进治疗效果。

Objective To study the nursing problems and strategies during the course of intravit- real injection of anti-vascular endothelial growth factor （anti-VEGF） agent. Methods We identified the nursing responsibilities involved in different stages of the intravitreal injection of anti-VEGF agent. Totally 218 cases （305 eyes） of fundus disease with intraocular neovascularization or macular exudation received in- travitreal injections of anti-VEGF agent in our department from April to September, 2012. Side effects of in- travitreal injections were observed. Medication compliance and return visit rate were analyzed. Results Collective health education and communication with patients, information checking, medicine management, sterile techniques and intensive observation of potential risks and complications during the perioperative peri- od of intravitreal injections were well performed. The return visit rate was 97.4%. We obtained well re-in- jection compliance of patients that 257 eyes （ 84.3% ） completed 3 to 5 injection. Short-term intraocular pressure changes immediately but transiently after intravitreal injections were observed. There were no case of endophthalmitis, retinal detachment, corneal edema, traumatic cataract or vitreous hemorrhage during the follow-up period. Conclusion Good perioperative nursing care in the intravitreal injection of anti-VEGF a- gent can help to increase patient compliance, reduce risks and improve patient outcomes.