摘要
目的探讨双侧视神经损伤经鼻内镜手术的治疗效果及相关护理策略。方法对8例双侧外伤性视神经损伤导致失明的患者采用术前综合性药物治疗，并行鼻内镜双侧视神经减压手术，观察其疗效。围手术期做好患者心理护理及相应护理措施。结果8例患者中，2例伤后立即失明的患者，术后双侧视力均未恢复；2例外伤昏迷醒后失明的患者，术后双侧视力部分恢复；其余4例伤后逐渐失明患者的视力治疗后均有不同程度的恢复。对8例患者重点进行围手术期并发症观察、药物不良反应观察及围手术期心理护理，住院期间患者未出现相关护理事件。结论双侧外伤性视神经损伤导致失明，对患者造成严重心理和生理影响，应积极采用鼻内镜手术治疗，即使长时间失明者仍有恢复视力的可能性，伤后视力逐渐丧失或遗留残余视力是手术治疗有效的基本依据，伤后立刻失明者视力恢复的可能性较小。适当的心理护理和对应护理措施可保证患者平稳渡过围手术期。
Objective To explore the therapeutic efficacy and nursing experience of nasal endoscopic surgery for bilateral traumatic optic neuropathy. Methods 8 completely blind patients resulting from bilateral traumatic optic neuropathy received nasal endoscopic optic nerve decompression （NEOND） combined with all-around medication treatment. The curative effect was observed, and mental care and relevant nursing were performed. Results The vision of all patients improved except 2 patients who lost vision immediately after trauma. Nursing care focused on perioperative complication observation, medication adverse effect observation and nursing care of original disease and mental disease, basic nursing care. There was certain effect for corresponding nursing measures without occurrence of nursing events during hospital stay. Conclusions NEOND can be an effective treatment for bilateral traumatic blindness, even delayed NEOND may be effective. Both gradual vision loss and residual vision might be indications for an effective NEOND, but immediate blindness after injury might be an indication for poor result of NEOND. Suitable psychological and related nursing care are useful for patients in perioperative period.
出处
《国际医药卫生导报》
2015年第4期451-454,共4页
International Medicine and Health Guidance News
基金
广东省科技计划项目（20138022000059）
关键词
双侧视神经损伤
减压术
护理
Bilateral optic nerve injuries
Decompression
Nursing care
