摘要
目的探讨微创25G+闭合式玻璃体切除术联合微创2 mm切口白内障超声乳化术的护理特点、护理配合和注意事项,为将来微创前后节联合手术的规范化护理作准备。方法护理配合2013年7月—2016年3月浙江省丽水市人民医院眼科67例患者作25G+微创闭合式玻璃体切除术联合2 mm切口晶状体超生乳化术。除眼外科手术常规护理,特别要注意切割频率快慢、指眼球壁的软硬、超声乳化的超声能量大小及超声乳化和玻璃体切除时负压高低。微创前后节联合手术有特殊环节配合根据需要及时调整超乳机和玻切机各项参数,保证仪器和器械的正常使用,积液盒内的液体不宜过满,推注针头连接硅油推注器宜紧密,推注时动作均匀、缓慢、持续,以免引起网膜下积气。结果微创前后节联合手术后67眼中,到最后一次随访时,67眼均有不同程度的视力改善,其中65眼视力提高2行或以上。术后无明显角膜水肿及角膜内皮失代偿发生。9眼糖尿病牵拉性视网膜脱离于术后追加光凝。结论 25G+微创玻璃体切除术联合2 mm切口晶状体超乳术有其特殊的护理特点。术中密切配合手术过程,根据需要及时调整超乳机和玻切机模式、各项参数,保证仪器和器械的正常使用,手术中变化多、难度大,深入熟悉器械的性能和技能,紧密配合,才能确保25G+微创闭合式玻璃体切除术联合2 mm切口晶状体超生乳化术的顺利完成。
Objective To explore the nursing features,nursing cooperation and matters needing attention of patients with25 G ＋ minimally invasive closed vitrectomy combined with 2 mm micro incision phacoemulsification and to prepare for standardized nursing of minimally invasive combined anterior and posterior operation. Methods Nursing care includes67 cases of 25 G ＋ minimally invasive closed vitrectomy combined with 2 mm incision phacoemulsification surgery from July,2013 to March,2016,Zhejiang Department of Ophthalmology,Lishui People＇s Hospital. In addition to the routine care of eye surgery,we should particular pay attention to the frequency of cutting speed,referring to the soft and hard wall of the eye wall,the size of the ultrasound energy,and the level of negative pressure with phacoemulsification and vitrectomy. Minimally invasive surgery of anterior with posterior segment has a special link to the timely adjustment of phaco machine and vitrectomy machine parameters according to the needs,to ensure the normal use of instruments and equipment. Liquid effusion box should not be too full,injection needle injector should be closely connected with silicone oil injection,uniform,slow and sustained action,so as to avoid the omentum under the gas accumulation. Results In the eyes of 67 eyes who received minimally invasive combined anterior and posterior surgery,67 eyes had different degrees of vision improvement at the last follow-up,and 65 of them had visual acuity increased by 2 lines or more. No obvious corneal edema and corneal endothelial decompensation occurred after surgery. Besides,9 eyes of diabetic traction retinal detachment were added after surgery. Conclusion Special characteristics of nursing were found in 25 G ＋ minimally invasive vitrectomy combined with 2 mm incision phacoemulsification. Close cooperation was made during operation according to the operation process,the need for timely adjustment of phaco machine and vitrectomy machine mode as well as parameters,to ensure the normal use of instruments and equipment,and more changes in the operation difficulty,deeply familiar with equipment performance and skills,and close cooperation,to ensure the success of the 25 G ＋ minimally invasive closed vitrectomy combined with 2 mm micro incision phacoemulsification.
出处
《中华全科医学》
2018年第3期498-500,共3页
Chinese Journal of General Practice
基金
浙江省科技厅项目(2013T301-14)
关键词
微创
玻璃体切除
超生乳化
护理配合
Minimally invasive
Vitrectomy
Phacoemulsification
Nursing cooperation
