眼科结膜囊冲洗一次性洗眼包的研发与应用

Development and application of a disposable eyewash kit for conjunctival sac rinsing in ophthalmology

目的解决眼科结膜囊冲洗过程中患者体验感差、舒适度低下,使用传统受水器时流程繁琐的问题,提高医护人员工作效率。设计随机对照临床试验。研究对象2019年4-7月于温州医科大学附属眼视光医院屈光手术临床中心行激光角膜屈光手术患者106例。方法采用随机数字表法将106例患者分为试验组和对照组各53例。试验组使用自行设计的一次性洗眼包进行结膜囊冲洗,对照组使用传统不锈钢漏斗式受水器,记录两组结膜囊冲洗所需的时间。采用自行设计的调查表调查两组患者的满意度及医护人员在操作过程中用物准备、头位约束、倒液、器具调整的情况。主要指标结膜囊冲洗操作时间、患者满意度、操作简便性。结果试验组结膜囊冲洗操作时间为120(117.5,139.5)秒,明显低于对照组的(177.58±25.38)秒(U=106.50,P<0.001)。患者满意度调查中,试验组患者四肢活动度没有受限的人数占75.47%,明显多于对照组的43.37%(χ^(2)=15.42,P<0.001);试验组需要自己或他人帮助固定受水器的人数为0,明显少于对照组的100%(χ^(2)=102.04,P<0.001);试验组器具贴合皮肤无不适的人数占75.47%,明显高于对照组的39.62%(χ^(2)=28.31,P<0.001);试验组在操作过程中无漏水的人数占84.91%,明显高于对照组的37.74%(χ^(2)=26.00,P<0.001)。试验组操作时需要用物准备、头位约束、反复倒液、器具调整的人数为0,明显少于对照组的100%(χ^(2)=36.1,P<0.001)。结论自行设计的一次性洗眼包应用于眼科结膜囊冲洗时能提高患者舒适度、提高医护人员工作效率,有一定临床推广应用的价值。

Objective To solve the problems of poor patient experience and comfort during ophthalmic conjunctival sac irrigation and cumbersome processes when using traditional water receivers,and to improve the efficiency of healthcare professionals.Design Randomized controlled clinical trial.Participants 106 patients who underwent laser keratoconus refractive surgery from April to July 2019 at the Refractive Surgery Clinical Center.Methods The 106 patients were divided into 53 cases each in the experimental group and the control group using the randomized numerical table method.The experimental group used the self-designed disposable eyewash bag for conjunctival sac irrigation,and the control group used the traditional stainless-steel funnel-type aqueous humor.The time required for conjunctival sac irrigation was recorded for both groups,and a self-designed questionnaire was used to investigate the satisfaction of the patients of the two groups as well as the preparation of the objects,the restraint of the head position,the pouring of liquid,and the adjustment of instruments by the medical staff during the operation.Main Outcome Measures Conjunctival sac irrigation operation time,patient satisfaction,ease of operation.Results The operation time of conjunctival sac rinsing in the experimental group was 120(117.5,139.5)seconds,which was significantly shorter than that of(177.58±25.38)seconds in the control group(U=106.50,P<0.001).In the patient satisfaction survey,the number of patients in the experimental group with no limb mobility limitation accounted for 75.47%,which was significantly more than the 43.37%in the control group(χ^(2)=15.42,P<0.001);the number of patients in the test group who needed their own or other people's help in fixing the recipient apparatus was 0,which was significantly less than the 100%in the control group(χ^(2)=102.04,P<0.001);the number of people in the experimental group whose instruments fit the skin without discomfort was 75.47%,which was significantly higher than that of the control group,which was 39.62%(χ^(2)=28.31,P<0.001);the number of people in the experimental group who had no leakage during operation was 84.91%,which was significantly higher than that of the control group,which was 37.74%(χ^(2)=26.00,P<0.001).The number of people in the experimental group who needed preparation of supplies,head position restraint,repeated pouring of fluid,and adjustment of instruments during operation was 0,which was significantly less than 100%in the control group(χ^(2)=36.1,P<0.001).Conclusion The self-designed disposable eyewash bag can improve the comfort of patients and the efficiency of healthcare personnel when applied to ophthalmic conjunctival sac irrigation,and it has certain value for clinical promotion and application.