目的：观察表面麻醉下不同吸氧方式对白内障超声乳化手术患者生命体征变化的影响，探讨适宜的超声乳化手术中吸氧的方式。方法：选取2020年4月至2020年9月于中山大学中山眼科中心行白内障超声乳化摘除术的患者291例，随机分成3组，分别为简易面罩吸氧组(面罩组)97例、鼻导管吸氧(鼻导管组)97例、无吸氧组(对照组)97例，其中面罩组和鼻导管组的吸氧流量均为氧流量2~4 L/min。监测患者进入手术室时(T0)、手术开始时(T1)以及手术结束时(T2)的血压、心率以及血氧饱和度(SpO2)。结果：三组患者在进入手术间时生命体征差异无统计学意义，三组患者术中 血压变化不显著(P>0.05)。在T2时点，氧气吸入的患者其SpO2高于对照组(P<0.05)，但均在正常范围内。结论：表面麻醉下白内障超声乳化手术的患者在无严重基础疾病的情况下，术中适当吸氧及监测血流动力学可以增加患者的舒适度及临床安全，对患者使用的吸氧方式应以不影响术中操 作及患者舒适度的方式。
Objective: To observe the effects of different oxygen inhalation methods on the changes of vital signs in adult patients undergoing phacoemulsification under topical anesthesia, and to explore the appropriate oxygen inhalation methods in phacoemulsification. Methods: A total of 291 patients who underwent phacoemulsification for cataract extraction in Zhongshan Ophthalmic Center, Sun Yat-sen University from April 2020 to September 2020 were randomly divided into 3 groups: the simple mask oxygen inhalation group (n=97), the nasal catheter oxygen inhalation group (n=97), and the oxygen-free group (n=97). The oxygen flow of the mask group and the nasal catheter group was 2–4 L/min. Blood pressure, heart rate, and oxygen saturation (SpO2) were monitored at entry into the operating room (T0), at the beginning of surgery (T1), and at the end of surgery (T2). Results: There was no significant difference in vital signs among the 3 groups when entering the operating room, and no significant change in intraoperative blood pressure among the 3 groups (P>0.05). At T2, the blood oxygen saturation of patients with oxygen inhalation was higher than that of the oxygen-free group (P<0.05), but within the normal range. Conclusion: For cataract phacoemulsification patients under topical anesthesia without serious comorbidities, appropriate oxygen inhalation and monitoring hemodynamics can increase the comfort and safety of patients, and oxygen inhalation should be used without affecting surgery manipulation and comfort of patient.
目的：了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容，为医护人员制订居家照护支持计划提供依据。方法：采用描述性质性研究方法，于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈，采用归纳式内容分析法对访谈资料进行分析。结果：重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变；护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论：重度视力损伤和盲患者居家照护存在诸多的护理问题及需求，患者希望得到多维度相关知识和多渠道医疗咨询，医院、社区应该高度重视此类患者，同时给予相应的指导和帮助，从而提高患者的居家生活质量。
Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.
