论著

白内障手术患者围手术期非甾体抗炎滴眼液使用合理性分析

Analysis of the rational use of nonsteroidal antiinflammatory eye drops in perioperative patients undergoing cataract surgery

:515-521
 
目的: 探讨白内障手术患者围手术期非甾体抗炎药(non-steroidal anti-inflammatory drugs, NSAIDs)滴眼液应用的合理性,为优化临床用药方案提供依据。方法:采用回顾性研究方法,分析郑州市第二人民医院2024年100例(100眼)行白内障超声乳化并人工晶状体植入手术患者的临床数据,依据药品说明书、《我国白内障围手术期非感染性炎症反应防治专家共识(2015年)》《中国成人白内障摘除手术指南(2023年)》《中国激光角膜屈光手术围手术期用药专家共识(2024年)》等指南/共识制定评价标准,评价NSAIDs滴眼液的用药频次、疗程及术前预防性抗炎处理的规范性。结果:35%的病例存在用药不合理,共发现88项问题,包括用药频次错误(7.96%)、超疗程(22.72%)及术前用药不当(69.32%)。其中,65%糖尿病患者术前未启动NSAIDs预处理,41%非糖尿病患者术前1 d使用NSAIDs;溴芬酸钠滴眼液疗程超过10天者占20.45%,可能增加肝损伤风险。结论:医疗机构应采取积极有效措施,如制定个体化用药方案、加强合理用药培训、开展专项处方点评等,切实促进NSAIDs滴眼液在白内障手术患者围手术期的合理使用,保障患者的用药安全与治疗效果,提高医疗服务质量和患者满意度。
Objective: To investigate the rationality of perioperative application of non-steroidal anti-inflammatory drugs (NSAIDs) eye drops in patients undergoing cataract surgery, thereby providing evidence for optimizing clinical medication protocols. Methods: A retrospective study method was used to analyse the clinical data of 100 patients (100 eyes) who underwent cataract ultrasonoemulsification with IOL implantation in 2024 at the Second People's Hospital of Zhengzhou City, and the evaluation criteria were developed based on the instructions of the medication, the Chinese expert consensus on prevention and management of non-infectious inflammatory responses in the perioperative period of cataract surgery (2015), the Chinese guideline for cataract surgery in adults (2023), and the Chinese expert consensus on the perioperative medication in laser corneal refractive surgery(2024)" and other guidelines/consensus to develop evaluation criteria to evaluate the standardisation of NSAIDs eye drops in terms of frequency of dosing, duration of treatment, and preoperative prophylactic anti-inflammatory treatment. Results: Irrational medication use was identified in 35% of cases, with a total of 88 issues categorized as follows: incorrect dosage frequency (7.96%), prolonged treatment duration (22.72%), and inappropriate preoperative medication (69.32%). Notably, 65% of diabetic patients failed to initiate NSAIDs pretreatment preoperatively as recommended by guidelines, while 41% of non-diabetic patients received NSAIDs one day before surgery. Prolonged use of bromfenac eye drops (>10 days) was observed in 20.45% of cases, potentially increasing the risk of liver injury. Conclusions: Medical institutions should take active and effective measures, such as formulating individualised medication plans, strengthening training on rational use of medication, and carrying out special prescription reviews, etc., to effectively promote the rational use of NSAIDs eye drops in the perioperative period of patients undergoing cataract surgery, to safeguard the safety of patients' use of medication and therapeutic efficacy, and to improve the quality of healthcare services and patients' satisfaction.
论著

Meta-analysis of the eff ect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy

Meta-analysis of the eff ect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy

:171-175
 
Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.
Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.
Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).
Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.
Background: The effect of perioperative injection of Lucentis on intraoperative bleeding in patients with proliferative diabetic retinopathy (PDR) was systematically evaluated using a meta-analysis.
Methods: Reports of surgical eye treatment with and without perioperative intravitreal injection of Lucentis in Medline, the Cochrane Library, PubMed, the Chinese Biomedical Literature Database, and China Academic Journals Full-text Database were included in the study. A meta-analysis was performed on all included literature. A computerized search was performed in the above databases. In addition, relevant books, journals, and conference proceedings and their bibliographies were manually searched. Published literature was screened according to the inclusion and exclusion criteria. Data extraction was performed on included studies. RevMan5.2 software was used for the statistical analyses. Dichotomous variables are presented as odds ratios (ORs) and 95% confidence intervals (CIs). The major indicator was the occurrence of intraoperative retinal hemorrhaging during vitrectomy.
Results: A total of seven studies were included in the analysis. The treatment group included 159 eyes and control group included 149 eyes. The amount of intraoperative bleeding in the treatment group (perioperative Lucentis injection) was significantly lower than that in the control group (OR, 56.93; 95% CI: 21.81-148.57, P<0.01).
Conclusions: Intravitreal Lucentis injection before a vitrectomy significantly reduced intraoperative bleeding in PDR patients.
眼科护理

15 例自膨胀水凝胶眶内植入术患儿的围手术期护理

Perioperative nursing of 15 children with self-expanding hydrogel orbital implantation

:177-180
 

本文总结了 15 例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查,给予患儿及其家属个性化的心理护理,进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理,饮食、疼痛、眼部用药以及弹力绷带包扎护理,关注有无并发症的发生及给予相应的护理,并对患儿及其家属做好出院指导。15 例患儿均顺利完成手术,术后均出现术眼疼痛,例出现眶压增高,例出现呕吐,均得到妥善处理。术后随访 3~18 个月,患儿均获得了较为满意的眼部外观,生活质量得到了提高。

This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 318 months, 15 children were satisfied with the appearance of the eye, and the life quality was improved. 

论著

小儿角膜移植围手术期护理

Perioperative care for corneal transplantation in children

:219-222
 
目的:减轻行角膜移植术的患儿及家属的心理负担,提高患儿对手术的耐受性,减少术后并发症。方法:对45例将进行角膜移植的患儿进行围手术期护理。结果:所有患儿经过精心的治疗和护理后均恢复良好,视力均有提高。结论:术前做好充足的准备、术前心理护理,术后严密观察生命体征和眼部敷料的情况,做好相关的生活和饮食指导,遵医嘱及时有效用药,注意患儿异常的反应及眼部的情况,及时发现并处理并发症,给予细致的出院指导,有利于患儿早日康复。
Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. Affer operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery.
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.
眼科护理

15例自膨胀水凝胶眶内植入术患儿的围手术期护理

Perioperative nursing of 15 children with self-expanding hydrogel orbital implantation

:177-180
 
本文总结了15例自膨胀水凝胶眶内植入术患儿围手术期的护理要点。术前主要评估患儿是否完善术前检查,给予患儿及其家属个性化的心理护理,进行术前准备以及禁食禁饮的管理。术后主要给予患儿安全管理,饮食、疼痛、眼部用药以及弹力绷带包扎护理,关注有无并发症的发生及给予相应的护理,并对患儿及其家属做好出院指导。15例患儿均顺利完成手术,术后均出现术眼疼痛,2例出现眶压增高,1例出现呕吐,均得到妥善处理。术后随访3~18个月,患儿均获得了较为满意的眼部外观,生活质量得到了提高。
This paper summarized the nursing experience of 15 children with self-expanding hydrogel orbital implantation during perioperative period. Before operation, children were fully evaluated, given with psychological care, preoperative preparation and management of fasting and drinking. After the surgery, the patients were mainly given with safety management, diet, pain, medicine and elastic bandage dressing care. Nurses should pay attention to the occurrence of complications and give corresponding nursing care and offer useful discharge guidance for the children and their parents. All 15 children completed the operation successfully, postoperative eye pain occurred in 15 cases after operation, and the orbital pressure increased in 2 cases, 1 case vomited, and all cases were properly treated. After postoperative follow-up for 3–18 months, 15 children were satisfied with the appearance of the eye,and the life quality was improved.
眼科护理

先天性瞳孔残膜围手术期的护理

Perioperative nursing of persistent pupillary membrane

:264-267
 
目的:探讨先天性瞳孔残膜围手术期的护理方法。方法:对13例(15眼)先天性瞳孔残膜患儿围手术期给予心理护理、安全护理、优先安排术前检查、术后严密观察病情变化、延续性护理并观察其效果。结果:13例(15眼)先天性瞳孔残膜的患儿手术均顺利完成,术后均无出现并发症,其中6例患者术后视力较术前视力有所提高,住院满意度为92.3%(12/13)。结论:对先天性瞳孔残膜患儿围手术期给予针对性的心理护理、安全护理、延续性护理是瞳孔残膜围手术期的有效护理方法。
Objective: To explore the perioperative nursing methods of persistent pupillary membrane. Methods: In the perioperative period, 13 cases (15 eyes) with persistent pupillary membrane were given preoperative nursing care, psychological nursing, careful observation of the change of condition, safety nursing, continuous nursing and observation of its effect. Results: A total of 13 cases (15 eyes) with persistent pupillary membrane were successfully operated, among which 6 cases had improved postoperative visual acuity compared with preoperative visual acuity, and no postoperative complications occurred. The satisfaction rate of hospitalization was 92.3% (12/13). Conclusion: It is an effective nursing method to give psychological nursing, safety nursing and continuous nursing to children with persistent pupillary membrane in perioperative period.
论著

全飞秒激光小切口角膜基质透镜取出术患者围手术期体验的质性研究

Perioperative experience in small incision lenticule extraction patients: a qualitative study

:149-153
 
目的:了解行全飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)患者围手术期的体验感受。方法:采用定性调查的方法,选取广东省某医院的15名行SMILE的患者,进行半结构式访谈,将患者围手术期体验归纳为顾虑、紧张、疼痛、担心、放松5个主题概念,用现象学分析法整理、分析资料。结果:把5种体验汇总制成韦恩图,通过韦恩图提炼发现有1人有围手术期5种感受,3位有紧张、疼痛、担心、放松4种心理感受,2位只有紧张的感受,而无其余感受。结论:行SMILE患者的围手术期具有多种体验感受,分析不同感受状态和因素,为眼科医护人员对于寻求SMILE手术的患者做好围手术期的服务提供依据。
Objective: To investigate the perioperative experience after small incision lenticule extraction (SMILE). Methods: A semi-structured interview was conducted in 15 patients who underwent SMILE surgery in Zhuhai People’s Hospital.The data were collected and analyzed by phenomenological analysis. Results: The perioperative feelings of patients were summarized into five categories: concern, tension, pain, worry and relaxation. These feelings were compiled and extracted by Venn diagram. One patient had all five categories of feelings during the perioperative period. Three patients experienced four psychological feelings of tension, pain, worry and relaxation, and 2 patients had only nervous feelings during the full femtosecond operation period. Conclusion: Patients undergoing SMILE have avariety of experience feelings during perioperative period. Analysis of different feeling states and factors will provide evidence for ophthalmic medical staff to provide perioperative services for patients seeking SMILE surgery.
8

小儿角膜移植围手术期护理

Perioperative care for corneal transplantation in children

:-
 
[摘 要] 目的:减轻行角膜移植术的患儿及家属的心理负担,提高患儿对手术的耐受性,减少术后并发症。方法:对45例将进行角膜移植的患儿进行围手术期护理。结果:所有患儿经过精心的治疗和护理后均恢复良好,视力均有提高。结论:术前做好充足的准备、术前心理护理,术后严密观察生命体征和眼部敷料的情况,做好相关的生活和饮食指导,遵医嘱及时有效用药,注意患儿异常的反应及眼部的情况,及时发现并处理并发症,给予细致的出院指导,有利于患儿早日康复。
Abstract Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. After operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery
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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