视网膜脱离患者眼内短期填充过氟氢菲液体的护理

Nursing of retinal detachment patients with eyes temporarily stuffed with vitreon liquid

笔者总结了6例(6只眼)复杂性视网膜脱离的患者行玻璃体手术、过氟氢菲液体填充手术的护理体会。术前做好解释工作,取得患者的理解和配合;术后做好基础护理,加强观察病情变化。与硅油的术后护理相比,过氟氢菲液体填充的优点在于术后患者无需特殊体位,从而减少患者不适及术后并发症,特别适用于年老体弱、伴有心肺疾患及小儿等患者。但过氟氢菲液体作为眼内短期填充物有较多并发症,其理化特性还有待改进。本组病例中,2例患者出现角膜水肿,虹膜后粘连;2例出现前房内过氟氢菲液体-房水平面;2例出现高眼压;3例出现晶体后囊下棕色颗粒状混浊、经密切观察病情变化,给予相应的护理措施后,4w内行氟氢菲液体取出术,术后患者眼压恢复正常,晶体混浊消失。

In this paper the authors summarize their experience of nursing 6 complex retinal detachment eyes treated with vitreous removal and temporarily stuffed with vitreon liquid. They argue that preoperative explanation for patients should be done to obtain their understanding and cooperation; postoperative basic nursing should be enhanced to observe changes. They think vitreon is superior to silicon gel in that the use of it avoids patients' fixed postures at operation so as to reduce their discomfort and postoperative complications. Therefore , it is apt to the aged babies and those with poor health or cardiopulmonary diseases. However vitreon as short-term stuff can lead to many complications because of its physicochemical property. In the 6 cases. 2 of them occurred to have corneal edema and posterior synechia; 2 had vitreon aqueous plane in anterior chamber; 3 had brown granule opacity at posteroinferior crystal. After close observation and proper nursing care were performed, the cases received vitreon removal in 4 w. After operation, their intraocular pressure resumed to normal and the crystal opacity disappeared.