整体围术期护理干预对老年糖尿病性白内障患者行小切口白内障摘除术预后的影响

Effect of Holistic Perioperative Nursing Intervention on the Prognosis of Small Incision Cataract Extraction in Elderly Patients with Diabetic Cataract

目的研究整体围术期护理干预对老年糖尿病性白内障(DC)患者行小切口白内障摘除术预后的影响。方法选取2015年9月-2020年9月天津医科大学第二医院收治的60例老年DC患者,所有患者均接受小切口白内障摘除术治疗,参照随机数字表法分为对照组(30例)与观察组(30例)。对照组行常规围术期护理干预,观察组应用整体围术期护理干预,比较两组血糖水平[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、负面情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、眼表参数(平均泪膜破裂时间、眼红指数、角膜内皮计数)、手术并发症及护理满意度。结果两组FPG、HbA1c均有下降,且观察组低于对照组(P<0.05);两组SAS、SDS评分均有下降,且观察组低于对照组(P<0.05);观察组术后平均泪膜破裂时间、角膜内皮计数高于对照组,眼红指数小于对照组(P<0.05);观察组手术并发症发生率低于对照组,护理满意度高于对照组(P<0.05)。结论整体围术期护理干预在老年DC患者小切口白内障摘除术中具有较高应用价值,可加强患者的血糖管理,疏导其负面情绪,缓解手术引起的眼表损害,降低手术并发症风险,满意反馈度高。

Objective To study the effect of holistic perioperative nursing intervention on the prognosis of small incision cataract extraction in elderly patients with diabetic cataract(DC).Methods A total of 60 elderly patients with DC admitted to the Second Hospital of Tianjin Medical University from September 2015 to September 2020 were selected.All patients underwent small incision cataract extraction.According to the random number table method,they were divided into control group(30 patients)and observation group(30 patients).The control group received routine perioperative nursing intervention,and the observation group received holistic perioperative nursing intervention.The blood glucose levels[fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)],negative emotions[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],ocular surface parameters(mean tear film rupture time,redness index,corneal endothelial count),surgical complications and nursing satisfaction were compared between the two groups.Results FPG and HbA1c decreased in both groups,and those in the observation group were lower than those in the control group(P<0.05).The scores of SAS and SDS in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).The average tear film rupture time and corneal endothelial count in the observation group were higher than those in the control group,and the redness index was lower than that in the control group(P<0.05).The incidence of surgical complications in the observation group was lower than that in the control group,and the nursing satisfaction was higher than that in the control group(P<0.05).Conclusion Holistic perioperative nursing intervention has high application value in small incision cataract extraction in elderly DC patients,which can strengthen the blood glucose management of patients,ease their negative emotions,alleviate the ocular surface damage caused by surgery,reduce the risk of surgical complications,and have high satisfaction feedback.