Ex—PRESS引流器植入治疗外伤性青光眼的术后护理

Postoperative nursing of traumatic glaucoma patients with Ex-PRESS glaucoma filtration device implantation

目的探讨Ex-PRESS青光眼引流器植入术治疗外伤性青光眼的术后观察与护理要点。方法回顾性分析19例（19只眼）外伤性青光眼患者的临床资料，所有患者均实施巩膜瓣下Ex-PRESS青光眼引流器植入术。术后观察患者视力、前房深度、前房积血、眼压及滤过泡情况，实施并总结规范的术后护理。结果术后3个月矫正视力提高2～3行者9只眼（47．4％），矫正视力不变者（含视力增加或减少1行）9只眼（47．4％），矫正视力下降2～3行者1只眼（5．3％）。术后第1天发生浅前房者2只眼（10．5％），给予复方托吡卡胺滴眼液散瞳1～4次，第2天前房均恢复正常深度。术后第1周内有19眼眼压值5～16mmHg。3个月时有1只眼呈包囊型滤过泡眼压偏高，眼压36mmHg；维持在9—17mmHg者18只眼。术后3个月滤过泡情况：Ⅰ型者3只眼，Ⅱ型者15只眼，Ⅳ型者1只眼，Ⅰ型和Ⅱ型者共18只眼，占94．7％，为功能性滤过泡。结论Ex-PRESS青光眼引流器植入治疗外伤性青光眼术后视力改善、目标眼压稳定。规范的术后护理有助于减少术后并发症、提高患者的手术治疗效果。

Objective To explore the postoperative observation and nursing points of traumatic glaucoma patients with Ex-PRESS glaucoma filtration device implantation. Methods The clinical data of 19 patients （19 eyes） with traumatic glaucoma were retrospectively analyzed, and all patients received the Ex-PRESS glaucoma filtration device implantation under the scleral flap. The visual acuity, anterior chamber depth and hyphema, intraocular pressure and filtering bleb after the operation were observed, and the standardized postoperative nursing was carried out and summarized. Results The cases of visual acuity with the increase of 2 to 3 lines, the unchanged including the increase or decrease of 1 line and the decrease of 2 to 3 lines were respectively 9 （47.4%）, 9 （47.4%） and 1 （5.3%） case 3 months after the operation. The cases of shallow anterior chamber were 2 cases （ 10. 5% ） one day after the operation, and the anterior chamber depth returned to normal on the second day after the operation through one to four mydriasis. The cases of intraocular pressure with 5 to 16 mmHg were 19 eases on the first week after the operation. The cases of intraocular pressure with 36 mmHg accompanied by filtering bleb were one case, and the cases of intraocular pressure with 9 to 17 mmHg were 18 cases 3 months after the operation. The cases of filtering bleb including Ⅰ, Ⅱ and Ⅳ were respectively 3, 15, 1 case 3 months after the operation, and the cases of functional filtering bleb including Ⅰ and Ⅱ were 18 cases （94.7%）. Conclusions Ex-PRESS glaucoma filtration device implantation can improve the postoperative vision, and ＇control the postoperative intraocular pressure in patients with traumatic glaucoma. The standardized postoperative nursing can reduce the postoperative complication, and increase the surgical effects.