针对性护理在高龄白内障合并青光眼围手术期患者中的应用

Application of Targeted Nursing in Perioperative Patients with Senile Cataract Complicated by Glaucoma

目的白内障合并青光眼就是患者既患有白内障,同时也有青光眼,这类患者,因其眼压升高造成的视功能损害是不可逆的,所以在治疗白内障的同时要积极治疗青光眼。加上患者高龄,常伴有基础性疾病,在一定程度上增加治疗难度。常规采用单纯的白内障手术难以完全控制眼压,通常都进行青光眼和白内障的联合手术。针对性护理对降低术后并发症,促进疗效有明显优势。因而本研究主要探讨高龄白内障合并青光眼患者围手术期实施针对性护理的应用效果,旨在患者中的应用价值。方法选择2018年1月至2020年1月在本院诊治的62例高龄白内障合并青光眼患者,按抽签的方式,将其均分为对照组(31例)和观察组(31例),分别予以常规护理和针对性护理。比较并分析两组患者视力情况、心理状态(SAS、SDS评分)以及并发症率、护理满意度。结果观察组患者视力值为(0.54±0.13)明显高于对照组视力值(0.36±0.08)(P<0.05);观察组SAS(31.16±8.25)分、SDS评分(33.05±7.41)分明显低于对照组的(42.56±9.13)分、(41.52±7.16)分,差异有统计学意义(P<0.05);观察组并发症率为6.45%明显低于对照组并发症率为19.31%(P<0.05);观察组患者对护理满意度96.67%明显高于对照组87.10%,差异有统计学意义(P<0.05)。结论在高龄白内障合并青光眼围手术期患者中实施针对性护理的效果在于:(1)由于青光眼造成的视力损伤是没有办法恢复,当青光眼进展到晚期时,视力也会出现下降,最严重的情况可以导致完全的失明,而在术后予以针对性护理能够有效促进患者视力恢复,帮助患者降低视功能的损害,控制失明的进程。(2)受疾病本身的影响,加上患者对手术期望值较高,极易在围手术期产生心理应激反应,针对性护理能够评估患者心理状态,予以针对性的个体化心理护理,可有效改善其不良情绪,稳定心态,有助于治疗和护理工作的顺利开展,利于康复。(3)手术毕竟是有创的,加上高龄患者自身抵抗力不高,极易出现各种并发症,通过予以针对性护理,全面评估患者病情,予以针对性护理有助于降低和预防并发症的发生,促进其恢复。(4)针对性护理能提高患者对护理满意度,具有显著的应用价值。

Objective Cataract combined with glaucoma means that patients have both cataract and glaucoma.Such patients,the visual function damage caused by their increased intraocular pressure is irreversible,so we should be actively treated with glaucoma in the treatment of cataract.In addition,the old age of patients,often accompanied by basic diseases,to increase the difficulty of treatment to a certain extent.It is difficult to completely control IOP with conventional cataract surgery alone,and combined surgery for glaucoma and cataract is usually performed.Targeted care has obvious advantages in reducing postoperative complications and promoting efficacy.Therefore,this study mainly discusses the application effect of targeted care in elderly patients with cataract and glaucoma,aiming at the application value in patients.Methods The 62 elderly patients with cataract and glaucoma treated in our hospital from January 2018 to January 2020 were selected and divided into control group(31 cases)and observation group(31 cases),and given routine and targeted care respectively.Visual acuity,psychological status(SAS,SDS score),and complication rate,and nursing satisfaction were compared and analyzed between the two groups.Results The visual acuity value of the observation group was(0.54±0.13)was significantly higher than that in the control group(0.36±0.08),the difference was statistical significant(P<0.05).The SAS(31.16±8.25)and SDS scores(33.05±7.41)were significantly lower than the controls(42.56±9.13),(41.52±7.16),the difference was statistical significant(P<0.05).The complication rate in the observation group was 6.45%significantly lower than the control complication rate of 19.31%(P<0.05).The observation group satisfied 96.67%with care significantly higher than 87.10%in the control group(P<0.05).Conclusion In the effect of targeted care in advanced cataract with glaucoma perioperative patients:(1)Visual damage due to glaucoma is no way to recover,when glaucoma progress to advanced,vision will decline,the most serious situation can lead to complete blindness,and postoperative targeted care can effectively promote visual recovery,help patients to reduce visual function damage,control the process of blindness.(2)Affected by the disease itself,coupled with patients with high expectations for surgery,easy to produce psychological stress in the perioperative period,targeted care can assess the patient’s psychological state,targeted individualized psychological care,can effectively improve its bad mood,stable mentality,conducive to the smooth development of treatment and nursing work,conducive to rehabilitation.(3)After all,the operation is invasive,and with the low resistance of the elderly patients,it is easy to cause various complications.Through targeted care and comprehensive assessment of the patient’s condition,targeted care can help to reduce and prevent the occurrence of complications and promote their recovery.(4)Targeted care can improve patient satisfaction with care and has significant application value.