肩颈操在玻璃体切割术后护理中的作用

Effect of shoulder and neck exercises on the nursing in patients receiving vitrectomy

目的探讨视网膜脱离行玻璃体切割术后患者肩部不适发生的相关原因,分析并制定相应的护理措施,避免和减少玻璃体切割术后患者肩部不适的发生。方法将2017年1月至3月南京医科大学附属眼科医院眼底病2个病区共200例视网膜脱离行玻璃体切割手术,术后执行俯卧位,主诉肩部不适的患者为观察对象,分为试验组(二病区100例)与对照组(三病区100例)。对照组采用常规护理模式;试验组在常规护理中增加肩颈操和肩颈按摩项目,由责任护士每天下午进行30 min肩颈操和肩颈穴位按摩护理,并指导正确的卧位,每2 h变换1次。比较两组患者舒适度的变化。结果经过3个月的观察与护理,试验组肩颈不适患者占有率40%,对照组肩颈不适患者占有率62%,两组比较差异有统计学意义(χ~2=9.683,P=0.001)。结论在正确执行俯卧位及2 h变换体位的前提下,适当的增加肩颈操及肩颈穴位按摩可以改善患者的术后不适情况。

Objective To investigate the causes of shoulder discomfort in patients with retinal detachment after vitrectomy,and explore nursing intervention to reduce the occurrence rate of shoulder discomfort.Methods From January to March 2017,200 cases with retinal detachment from the Ophthalmology Department of Nanjing Medical University were treated with vitrectomy.The prone position was performed,and the shoulder discomfort was mainly reported.All the patients were divided into control group where the routine nursing mode applied,and the experimental group where the massage of shoulder and neck applied on the basis of routine nursing mode.The responsible nurse performed the exercise of shoulder and neck for 30 minutes every afternoon and guided the position of exercises for shoulder and neck every 2 hours.The changes in comfort between the two groups were compared.Results After three months of nursing,the discomfort rate of patients in the experimental group was lower than that of control group significantly(40%vs 62%,χ^2=9.683,P=0.001).Conclusions Under the premise of correct implementation of prone position and 2 h change position,shoulder and neck acupressure can improve postoperative discomfort.