论著

甲状腺相关眼病患者的生活质量调查及护理对策

Investigation of quality of life and nursing of patients with thyroid associated ophthalmopathy

:80-83
 
目的:探讨与甲状腺相关眼病患者的生活质量,为做好个体化的护理提供理论依据。方法:采用甲状腺相关眼病的生活质量调查问卷进行调查,用R语言进行数据分析。结果:年龄与视功能评分成负相关(P<0.001,r=–0.504),与社会心理评分成正相关(P=0.002,r=0.327)。文化程度与视功能评分成正相关(P<0.001,r=0.391),与社会心理评分无相关关系(P=0.749)。不同症状的视功能评分之间差异有统计学意义(P<0.001)。结论:通过甲状腺相关眼病的生活质量调查问卷可知,年龄越大,视功能越差,不同症状的患者视功能情况不同,要关注年龄大、复视、视力差患者的安全;在护理上,要做好患者及其有甲状腺功能亢进史家属的健康宣教,尤其关注女性患者的社会心理状况。
Objective: To explore the factors related to the quality of life of patients with thyroid associated ophthalmopathy, and to provide theoretical basis for individual nursing. Methods: The quality of life questionnaire of thyroid associated ophthalmopathy was used to investigate, and the data were analyzed by R language. Results: There was a negative correlation between age and visual function score (P<0.001, r=-0.504), and positively correlated with social psychological score (P=0.002, r=0.327). There was a positive correlation between educational level and visual function score (P<0.001, r=0.391), and had no correlation with social psychological score (P=0.749). There were statistically significant differences in visual function scores among different symptoms (P<0.001).Conclusion: The quality of life of thyroid-related eye disease questionnaire showed that the older, the worse the visual function. Different symptoms of patients had different visual function. We should pay attention to the patients with older, diplopia and poor vision, do health education with the patients and family members with the history of hyperthyroidism as well, especially concern with the social and psychological status of female patients.
论著

2017~2023年期间眼科患者术前四项感染指标的结果分析

Analysis of four blood-borne pathogens in ophthalmic patients from 2017 to 2023

:1-9
 

目的:了解中国华南地区眼科患者近年术前四项指标的感染状况及阳性患者在不同眼病中的分布。方法:回顾性分析2017年1月~2023年12月在中山大学中山眼科中心进行乙型肝炎表面抗原(HBsAg)、丙肝肝炎病毒抗体(抗-HCV)、梅毒螺旋体抗体(抗-TP)、人类免疫缺陷病毒抗体(抗-HIV)指标筛查的门诊、手术和(或)住院患者资料,并记录和分析患者各项指标的阳性情况。结果:共纳入253 246例患者,HBsAg、抗-HCV、抗-TP和抗-HIV阳性率分别是9.00%、0.45%、1.55%、0.13%。两种或两种以上感染指标阳性的患者共有686例, HBsAg和抗HCV同时阳性的例数最高(57.29%),其次为抗-HIV和抗-TP(15.74%)。2017~2023年HBsAg阳性率逐年递减,而抗-HCV、抗-HIV、抗-TP阳性率变化不明显。男性的HBsAg、抗-HCV、抗-TP、抗-HIV阳性率均高于女性,差异均有统计学意义(<0.001)。HBsAg、抗-HCV、抗-TP、抗-HIV阳性率在不同年龄段比较差异均有统计学意义(<0.001)。在HBsAg、抗-HCV、抗-TP阳性患者中,晶状体病的病例数占比最高,分别为36.72%、39.12%、46.97%。其次是玻璃体/视网膜疾病,占比分别为22.52%、19.65%、19.69%。在抗-HIV阳性患者中,玻璃体/视网膜疾病的病例数占比最高,为42.99%,其次是晶状体病,占26.17%,葡萄膜炎占8.72%。结论:本研究揭示了眼科患者术前四项指标的感染情况及感染患者在不同眼病中的分布,这对于评估眼科手术风险、制定感染控制措施具有重要意义。

Objective: To understand the infection status of four blood-borne pathogens among ophthalmology patients in South China and the distribution of positive patients across different eye diseases. Methods: A retrospective analysis of data from outpatient and inpatient or surgical ophthalmic patients who underwent screening for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), treponema pallidum antibody (anti-TP) and human immunodeficiency virus antibody (anti-HIV) at Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2017 to December 2023. The positivity rates of these markers were recorded and analyzed. Results: A total of 253246 patients were included in the study, with positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV at 9.00%, 0.45%, 1.55% and 0.13%, respectively. Among these, 686 patients tested positive for two or more markers, with the highest co-positivity observed for HBsAg and anti-HCV (57.29%), followed by anti-HIV and anti-TP (15.74%). The positivity rate of HBsAg showed a yearly decline, while the rates for anti-HCV, anti-HIV, and anti-TP remained relatively stable from 2017 to 2023. Males had significantly higher positivity rates for HBsAg, anti-HCV, anti-TP, and anti-HIV compared to females (P < 0.001). Significant differences in positivity rates for these markers were also observed across different age groups (P < 0.001). In patients with positive HBsAg, anti-HCV, and anti-TP, the proportion of cases with lens diseases were the highest, at 36.72%, 39.12%, and 46.97%, respectively. Vitreoretinal diseases followed, with proportions of 22.52%, 19.65%, and 19.69%, respectively. Among patients with positive anti-HIV, the proportion of cases with vitreoretinal diseases was the highest, at 42.99%, followed by lens diseases at 26.17%, and uveitis at 8.72%. Conclusions: This study reveals the infection status of four blood-borne pathogens in ophthalmology patients and the distribution of infected patients across different eye diseases, which is significant for assessing the risks of ophthalmic surgery and formulating infection control measures.
论著

飞秒激光辅助角膜内皮移植术患者的护理

Nursing for the patients with femtosecond laser assisted corneal endothelial transplantation

:229-231
 
目的:探讨飞秒激光辅助角膜内皮移植(endothelial keratoplasty,EK)患者的护理。方法:对40例 行飞秒激光辅助EK术的患者做好术前心理护理,完善术前检查及术前准备,术后重点做好体位护 理、病情观察及出院指导。结果:4例患者术后发生植片移位,经再次复位后贴合良好,1例术后第1天气泡到后房行前房成形术;13例患者术后出现眼压升高,经治疗眼压得到控制;40例患者全 部治愈出院。结论:对EK术患者应做好术前及术后的护理,及时发现并发症并采取相应的治疗与护理措施,以提高手术的成功率。
Objective: To explore the nursing care of patients with femtosecond laser assisted endothelial transplantation. Methods: Forty patients were involved in this study. Preoperative psychological nursing, ocular examination, and surgical preparation were taken, and the main nursing postoperation focused on patients’ position and the discharge guidance. Results: TTe graffs in 4 cases were displaced, and were all in place affer resetting. The bubble was observed in posterior chamber in 1 case, this case was taken anterior chamber forming operation. Intraocular pressure was high in 13 cases, and those cases were treated with topical medicines. Conclusion: Completing the preoperative nursing of patients with corneal endothelial transplantation, observing the complications and taking corresponding treatment and nursing measures help improve the success rate of the operation.  

睡眠呼吸暂停综合征患者睡眠前后黄斑厚度改变的临床分析

The Change of Macular Thickness of SAS Before and After Sleep

:38-40
 

目的观察睡眠呼吸暂停综合征(Sleep apnea syndrome, SAS)患者睡眠前后黄斑厚度的改变。

方法选择 2003 年 8 月至 2007 年 1 月经确诊的在我院门诊和住院部治疗的 SAS 患者共 32 例(63 只眼),分别在上午 11:00 ~ 12:00(睡眠前)及患者晨起 20 ~ 30 分钟内(睡眠后)采用相干光断层扫描仪(Optical Coherence Tomography, OCT)进行黄斑中心凹厚度的测量。

结果睡眠前黄斑中心小凹平均视网膜厚度为(123.00 ± 19.98)μm,睡眠后黄斑中心小凹平均视网膜厚度为(134.25 ± 19.92)μm。睡眠后黄斑中心凹厚度比睡眠前厚度增加(11.25 ± 9.04)μm,95% 可信区间为(8.98,13.53)μm,差异有统计学意义(= 9.878,P < 0.05)。

结论睡眠呼吸暂停综合征患者睡眠时的缺血缺氧可以导致黄斑视网膜的水肿增厚。

Purpose: To observe the changes of macular thickness in patients with sleep apnea syndrome (SAS) before and after sleep.

Methods: Thirty-two patients (63 eyes) diagnosed as SAS from August 2003 to January 2007 were enrolled. Macular thickness was measured using Optical Coherence Tomography (OCT) at 11:00 ~ 12:00 evening (before sleep) and 20 ~ 30 minutes after sleep, respectively.

Results: The mean macular thickness was (123.00 ± 19.98) μm and (134.25 ± 19.92) μm before and after sleep, respectively. The mean difference was (11.25 ± 9.04) μm before and after sleep (t = 9.878, < 0.05), 95% CI (8.98, 13.53) μm.

Conclusions: The macular thickness of SAS is increased in SAS patients, which may be due to anoxia of SAS. 

论著

飞秒激光辅助角膜内皮移植术治疗大泡性角膜病变的患者围手术期护理

Perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy

:6-9
 
目的:探讨大泡性角膜病变(bullous keratopathy,BK)患者行飞秒激光辅助的角膜内皮移植术(endothelium keratoplasty,EK)的围手术期护理。方法:回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的BK20例患者,分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果:患者得到及时、有效的护理,术后视力均有所提高,内皮贴伏好,无排斥反应及其他并发症的发生。结论:通过对患者围手术期的护理,可提高护理质量,缩短患者住院时间。
Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing.

【test】超广角眼底成像在近视患者周边视网膜病变的临床应用

Clinical application of ultra-wide field laser ophthalmoscope in peripheral retinopathy in myopic patients

:-
 
目的:评价欧堡Daytona 200度超广角激光扫描检眼镜检查近视患者眼底周边部视网膜病变的应用价值。方法:本研究为前瞻性病例研究,收集爱尔眼科医院要求行屈光手术的近视患者1 000例(2 000只眼),分别进行小瞳下欧堡Daytona 200度超广角激光扫描检眼镜眼底检查和散瞳后三面镜检查,记录检查结果并进行比较分析。结果:通过欧堡Daytona 200度超广角激光扫描检眼镜检查发现有周边视网膜病变共230例(310只眼),检出阳性率为15.50%;三面镜检查发现周边部视网膜病变共242例(322只眼),检出阳性率为16.10%。两种检查方法对近视患者周边部视网膜病变检出阳性率具有很好的一致性(Kappa值0.8~1.0)。结论:欧堡Daytona 200度超广角成像系统为检查周边部视网膜病变提供了更省时高效的方法,在屈光手术前筛查视网膜周边部病变,具有广阔的临床应用前景。
Objectives: To evaluate the clinical value of peripheral retinal diseases in myopic patients examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona). Methods: This was a prospective case-control study. We collected 1 000 myopic patients (2 000 eyes) who were scheduled to undergo refractive surgery in Aier Eye Hospital. They were examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona) with non-mydriasis and three-mirror contact lens with mydriasis. The examination results were recorded and statistically analyzed. Results: A total of 230 cases (310 eyes) with peripheral retinopathy were found by 200-degree ultra-wide field laser ophthalmoscope (Daytona). The positive rate was 15.50%; 242 cases (322 eyes) with peripheral retinopathy were found by three- mirror contact lens, and the positive rate was 16.10%. The two methods were consistent in the detection of peripheral Retinopathy in myopic patients (the Kappa value is between 0.8 and 1.0). Conclusion: 200-degree ultra-wide field laser ophthalmoscope (Daytona) is an effective and rapid method for detecting peripheral retinopathy. It provides a broad clinical application prospects for peripheral retinopathy screening before refractive surgery.
论著

干眼患者自我护理能力水平现状及其影响因素研究

Research on self-care ability of patients with dry eye disease and analysis of its influencing factors

:11-18
 
目的:了解干眼患者自我护理能力水平并分析其影响因素。方法:选取2022年2月—6月在中山大学中山眼科中心就诊的干眼患者为研究对象,采用一般资料调查表、自我护理能力量表、一般自我效能感量表对患者进行调查分析。结果:共调查293例干眼患者,其自我护理能力评分为(113.34±9.98)分,处于中等水平。相关性分析中干眼患者的自我护理能力总分与自我效能感得分呈正相关(r=0.421,P<0.001),多重线性回归分析显示,累计屏幕使用时间>10 h/d、合并全身疾病、低自我效能感评分是干眼患者自我护理能力的危险因素(P<0.05)。结论:干眼患者自我护理能力水平处于中水平,仍需加强。医护工作者在工作中应重点关注屏幕使用时间长、合并全身疾病及自我效能感低的患者,并制定相应的护理对策,以改善患者的自我护理能力水平。
Objective: To understand the self-care ability of patients with dry eye and analyze its infuencing factors. Methods: A total of 293 patients with dry eye were selected from Zhongshan Ophthalmic Center, Sun Yat-sen University from February 2022 to June 2022, the general data Questionnaire the general self-efcacy scale, and the self-care ability scale survey were collected. Results: A total of 293 patients with dry eye were surveyed, and the self-care ability score was 113.34±9.98, which was at the medium level. The total score of self-care ability, the scores of self-concept, self-care responsibility, health knowledge level and self-care skills of patients with dry eye were positively correlated with the scores of self-efcacy (r=0.421, all P<0.001).Multiple linear regression analysis showed that cumulative screen usage time>10 hours/day, comorbid systemic diseases, and low self-efficacy scores were risk factors for self-care ability in patients with dry eye (P<0.05). Conclusions: Te self-care ability of patients with dry eye disease is at a medium level, and still needs to be strengthened. Medical workers should focus on patients with prolonged screen usage, comorbid systemic diseases, and low self-efficacy in their work, and tailor relevant nursing strategies to improve their self-care abilities.
论著

医护一体组团合作模式在眼底外科日间手术患者管理的应用研究

Study on the application of integrated medical and nursing group cooperation model in the management of day surgery patients in fundus surgery

:608-616
 
目的:探讨眼底外科医护一体组团合作模式在管理眼底病日间手术患者实践效果。方法:选取2022年1—6月进行日间手术的582例眼底病患者为对照组,2023年1—6月进行日间手术的633例眼底病患者为研究组,对照组实施责任制整体护理,研究组采取实施医护一体组团合作管理模式进行全流程患者管理。使用χ2检验和t检验比较两组患者围术期护理知识健康教育知晓度、满意度、出院24 h内眼科急症就诊率、出院24 h内随访率、护士职业获益感的差异。结果:研究组患者健康教育知晓度高于对照组,组间比较差异具有统计学意义(t=–18.47,P<0.05);研究组患者满意度高于对照组,组间比较差异具有统计学意义(t=–4.005,P<0.05);研究组患者出院24 h内随访率为100%,对照组为98.1%,两组比较差异有统计学意义(χ2=12.073,P<0.05);研究组患者出院24 h内眼科急症就诊率0.94%,对照组为1.89%,组间比较差异无统计学意义(χ2=1.951,P=0.222);实施后护士职业获益感分值高于实施前,组间比较差异具有统计学意义(t=–6.637,P<0.001)。结论:医护一体组团合作管理模式进行眼底外科日间手术患者围术期的全流程管理,改善患者就医感受,提升患者就医体验,提高眼底外专科日间手术患者的依从性,保障患者的安全,提高护士职业获益感。
Objective: To investigate the practical effect of the integrated group cooperation model in managing patients with fundus diseases in day surgery. Methods: 582 patients with fundus disease who underwent day surgery from January to June in 2022 were included as the control group, and 633 patients with fundus disease who underwent day surgery from January to June in 2023 were selected as the study group. The control group implemented the overall responsibility nursing system, while the study group carried out the collaborative management model, integrating medical and nursing for the entire process of patient management. Chi-square test and T-test were used to compare the differences of perioperative nursing knowledge, health education awareness, satisfaction, emergency ophthalmological consultation rate within 24 hours of discharge, follow-up rate within 24 hours of discharge, and nurses' sense of professional benefit between the two groups. Results: The awareness of health education in the study group was higher than that in the control group, and there was significant statistically difference between two groups (t=–18.47, P<0.05). The satisfaction of patients in the study group was higher than that in the control group, and there was significant statistically difference between two groups (t=–4.005, P < 0.05). The follow-up rate within 24 hours after discharge was 100% in the study group and 98.1% in the control group, and the difference was statistically significant (χ2=12.073, P<0.05). The incidence of ophthalmic emergencies within 24 hours of discharge in the study group was 0.94%, while in the control group it was 1.89%. There was no statistically significant difference between the two groups (χ2= 1.951, P=0.222). The perceived benefit score of nurses after implementation was higher than that before implementation, and there was statistically significant between two groups (t=–6.637, P<0.05). Conclusions: The medical and nursing integrated group cooperation management model is used to manage the entire perioperative process of patients undergoing day surgery in fundus surgery. This model can improve patients' medical experience, enhance their compliance with ophthalmic surgery, ensure their safety. At the same time, it can enhance the senses of professional benefits for nurses.
论著

斜视患者手术治疗后的眼表状况

Ocular surface condition after squint surgery

:159-162
 
目的:探索斜视患者手术治疗后的眼表恢复状况。方法:选取2015年1月至2018年6月于如皋市广慈医院接受门诊手术治疗的92例水平性斜视患者为研究对象,共126眼,按照手术切口将患者分为3组,行角膜缘切口的42例52眼患者为A组,行跨肌止端切口的17例19眼患者为B组,行近穹窿切口的33例55眼患者为C组。再根据手术累及肌肉条数将患眼分为3组,行单条眼外肌的29眼手术者为单肌组,行2条眼外肌的42眼手术者为双肌组,行3条眼外肌的21眼手术者为三肌组。比较不同切口类型和肌肉累及数患者的眼表健康恢复时间。结果:A,B,C3组间首次泪膜破裂恢复时间、泪河高度时间差异有统计学意义(P<0.05);A组首次泪膜破裂恢复时间(14.33±3.26) d和泪河高度时间(14.54±1.58) d显著低于B组和C组,差异具有统计学意义(F=4.876,P=0.032;F=4.612,P=0.036)。单肌组,双肌组及三肌组3组间首次泪膜破裂恢复时间、泪河高度时间差异有统计学意义(P<0.05);单肌组的首次泪膜破裂恢复时间(13.42±3.57) d和泪河高度时间(8.65±1.62) d显著低于双肌组和三肌组,差异有统计学意义(F=4.975,P=0.028;F=5.024,P=0.025)。结论:手术累及的肌肉数和手术切口类型对术后眼表健康状况具有重要影响,近穹窿切口的手术方式和累及较少肌肉数量有助于患者术后眼部健康状况的恢复。
Objective: To explore the ocular surface recovery after surgical treatment of strabismus patients. Methods: A total of 92 patients (126 eyes) with strabismus who underwent surgery in our hospital from January 2015 to June 2018 were enrolled. The patients were divided into three groups according to the surgical incision, 42 patients (52 eyes)underwent limbal incision were in group A, 17 patients (19 eyes) underwent trans-muscle end-point incision in group B, and 33 patients (55 eyes) underwent proximal hernia incision in group C. According to the number of muscles involved in the operation, the sick eyes of patients were divided into three groups. The 29 eyes with a single extraocular muscle were a single muscle group, the 42 eyes with 2 extraocular muscles were a double muscle group, and the 21-eye treated with 3 extraocular muscles were a three-muscle group. The ocular surface health recovery time of patients with different incision types and muscle involvement were compared. Results: The first tear film rupture recovery time and tear river height time between group A, B, and C were significantly different,and the data were statistically significant (P<0.05); the first tear film rupture recovery time (14.33±3.26) d and tear river height time (14.54±1.58) d in group A were significantly lower than those in group B and C. The data were statistically significant (F=4.876, P=0.032; F=4.612, P=0.036). The first tear film rupture recovery time and tear river height time between the single, double and three muscle groups were significantly different, and the data were statistically significant (P<0.05); the first tear film rupture recovery time (13.42±3.57) d and tear river height time (8.65±1.62) d were significantly lower in the single muscle group than in the double muscle group and the third muscle group. The data were statistically significant (F=4.975, P=0.028; F=5.024, P=0.025). Conclusion:The number of muscles involved in the operation and the type of surgical incision have an important impact on the health of the ocular surface after surgery. The proximal ankle incision and less number of muscles involved would improve the postoperative recovery of eye health.
论著

高度近视合并白内障患者术后有效晶状体位置的初步临床研究

Clinical study of effective lens position after cataract surgery in high myopia eyes

:136-140
 
目的:探讨高度近视合并白内障患者白内障术后有效晶状体位置的变化。方法:收集白内障超声乳化摘除联合人工晶状体植入术的高度近视合并白内障患者21例共27眼,记录术后1 d、1周、1个月视力、屈光度、有效晶状体位置。结果:高度近视合并白内障患者术后1 d,1周,1个月有效晶状体位置分别为(4.17±0.39),(4.09±0.38),(4.31±0.44) mm,且组间比较差异有统计学意义(P<0.05)。有效晶状体位置的实际轴向运动为(0.19±0.13) mm,与晶状体厚度呈正相关(r=0.648,P<0.001),与术前眼轴无相关关系(r=0.227,P=0.255)。结论:高度近视合并白内障患者术后1 d至1周人工晶状体轻度前移而造成近视偏移,而术后1个月时则呈远视偏移,且术后有效晶状体位置位移与术前晶状体厚度相关。
Objective: To investigate the change and influencing factors of the effective lens position after cataract surgery in high myopia eyes. Methods: We collected 27 eyes of 21 patients with high myopia who underwent phacoemulsification and intraocular lens implantation. The visual acuity, diopter and effective lens position were recorded 1 day, 1 week, and 1 month after operation. Results: The effective lens position of high myopia combined with cataract patients at 1 day, 1 week, and 1 month was (4.17±0.39), (4.09±0.38), and (4.31±0.44)mm, respectively. The effective lens positions significantly differed between the groups after surgery (P<0.05). The ELPRMS was (0.19±0.13) mm. The ELPRMS was positively correlated with the lens thickness (r=0.648,P<0.001), whereas was not correlated with the preoperative axial length (r=0.227, P=0.255). Conclusion: High myopic patients with cataract have a slight forward movement of the effective lens position from 1 day to 1 week after surgery, and a hyperopic shift from 1 week to 1 month. The displacement of effective lens position after surgery is correlated with the preoperative lens thickness.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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