眼科麻醉专题

24 180 例喉罩全身麻醉下接受眼科手术患儿麻醉复苏期的护理体会

Nursing experience of 24,180 children undergoing ophthalmic surgery under general anesthesia with laryngeal mask during anesthesia recovery period

:554-562
 
目的:探讨提高眼科喉罩全身麻醉患儿在麻醉恢复室(post-anesthesia care unit, PACU)复苏质量与效率的整体护理策略。方法:选取2020年1月—2023年12月在中山大学中山眼科中心行眼科全身麻醉并保留喉罩进入PACU复苏的24 180例患儿,总结患儿在PACU复苏的护理措施及复苏质量。结果:所有患儿经复苏期综合护理后均顺利拔除喉罩完成麻醉复苏,未发生苏醒期二次插管或非计划转院治疗。采取个性化的整体护理策略后,喉罩全身麻醉患儿PACU平均复苏时间明显缩短。部分术后常见并发症(术后躁动,低氧血症和呼吸道梗阻)和护理不良事件(留置针脱落和眼包脱落)发生率逐年降低,经治疗和护理后均获得改善。结论:针对眼科全身麻醉的患儿特点,在麻醉复苏期采取个性化的整体护理策略,有利于顺利完成麻醉复苏,降低麻醉并发症和护理不良事件的发生率,提高复苏质量效率,满足眼科日间手术快速康复的需求。
Objective: To explore holistic nursing strategies to improve the quality and efficiency of post-anesthesia care unit (PACU) resuscitation in childrenpatients undergoing ophthalmic laryngeal mask anesthesia. Methods: A total of 24,180 children patients who underwent general anesthesia and retained laryngeal mask airway for PACU resuscitation at Sun Yat-sen Ophthalmic Center of Sun Yat sen University from January 2020 to December 2023 was reviewed and summarized the nursing measures and resuscitation quality of children patients undergoing PACU resuscitation. Results: All patients underwent comprehensive care during the recovery period and successfully removed the laryngeal mask to complete anesthesia recovery. There were no cases of secondary intubation or unplanned transfer for treatment during the recovery period. After adopting personalized holistic nursing strategies, the average recovery time of PACU in children under laryngeal mask anesthesia was significantly shortened.The incidence of common postoperative complications(postoperative agitation, hypoxemia and respiratory obstruction)and adverse nursing events (indwelling needle falls off, eye bandage fall off)had been decreasing year by year. These complications had been improved after treatment and care. Conclusions: Based on the characteristics of children patients undergoing general anesthesia in ophthalmology, adopting personalized holistic nursing strategies during the anesthesia recovery period is beneficial for successfully completing anesthesia recovery, reducing the incidence of anesthesia complications and adverse nursing events, improving the quality and efficiency of recovery, and meeting the needs of rapid recovery in ophthalmic day surgery.
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

眼科全身麻醉手术患儿的个性化护理

Individual nursing on ophthalmic children under general anesthesia operation

:152-155
 
目的:探讨个性化护理在眼科患儿全身麻醉手术中的应用效果。方法:选取于2015年7月至2016年8月中山大学附属第一医院收治的50例眼科全身麻醉手术患儿,按手术例数单、双号顺序分组,单 数为对照组,采用传统常规护理,双数为观察组,采用个性化护理。比较两组麻醉配合度与家属对护理满意度。结果:50例患儿手术顺利。对照组在麻醉及复苏过程出现烦躁与躁动情况的患儿18例,观察组为3例,对照组明显高于观察组;观察组麻醉配合度与家属对护理满意度明显高于对照组,差异均有统计学意义(P<0.05)。结论:眼科全身麻醉手术患儿运用个性化护理,可改善患儿心理状态,提高配合度,增加患儿家属的满意度。
Objective: To detect the effect of individualized nursing on ophthalmic children under general anesthesia operation. Methods: Ophthalmic children under general anesthesia operation in First Afifliated Hospital of Sun Yat-sen University were included from July 2015 to August 2016. All of children were divided into odd and even groups by the operation sequence number. The children with odd numbers were in control group and accepted traditional nursing. The children with even numbers were in experimental group and accepted individualized nursing. Anesthesia cooperation degree and family members’ satisfaction on nursing were compared between the two groups. Results: Fifty operations were proceeded successfully. 18 children appeared irritability and restlessness during anesthesia and recovery process in the control group. Irritability and restlessness were only showed in 3 children in the experimental group. The satisfaction in experimental group was much higher than  the control group, the differences were statistically signiffcant (P<0.05). Conclusion: Individualized nursing can improve the mental state and the degree of cooperation. It can also improve family members’ satisfaction.  
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.
论著

智能语音随访系统在先天性白内障患儿术后随访中的应用与分析

Application and analysis of artificial intelligence voice system in postoperative follow-up of children with congenital cataract

:23-29
 
目的:探索智能语音随访系统在医疗场景中的新型应用服务模式并分析其在新冠肺炎疫情期间的应用效果,以此评估该系统应用于互联网医院开展医疗咨询服务的实际效能。方法:本研究应用智能语音随访系统针对先天性白内障患儿术后的常见问题进行回访。首先,针对随访目的,设计出完善的结构化随访内容与步骤。其次,部署智能外呼系统自动拨打用户电话,并通过语音识别技术对用户的每次应答进行识别,根据用户的应答自动跳转到下一个随访步骤,在完成一系列问答后根据用户的回答给出恰当的建议,实现电话随访的自动化与智能化。收集2020年2月24日至2月28日期间,智能语音随访系统随访的电话内容、呼叫时间、患儿资料等数据,采用描述性统计分析。结果:2020年2月24日至2月28日期间,中山大学中山眼科中心应用智能语音随访系统电话共随访1154例,其中收到有效回访数据561例,平均有效回访率48.6%。有效回访人群中,有204位(36.4%)家属认为疫情期间复诊时间延长,对宝宝眼睛的恢复有影响,309位(55.1%)家属认为对宝宝眼睛的恢复没有影响。360位(64.2%)先天性白内障患儿眼睛恢复情况良好,没有出现不良反应,169位(30.1%)患儿出现不良反应和体征,包括瞳孔区有白点,眼睛发红和有眼屎流眼泪等。统计患儿不同行为显示,有417位(74.3%)患儿佩戴眼镜,135位(24.1%)患儿没有佩戴眼镜,另有9位(1.6%)患儿佩戴眼镜情况不清楚,经常揉眼的患儿更容易出现眼睛发红(20.4%)、眼睛有眼屎或流眼泪(17.0%)和瞳孔区有白点(6.8%)等不良反应。结论:智能语音随访系统在临床随访中显示出巨大的应用潜力,可作为一种新型的智能医疗服务模式。
Objective: This study was designed to explore its potential value for new medical service model based on the intelligent voice follow-up system and analyze its application effect during the outbreak of COVID-19. The actual effectiveness of this intelligent voice follow-up system applied in the Internet hospital to carry out medical consultation service was discussed. Methods: In this study, an intelligent voice follow up system was developed for postoperative follow-up of children with congenital cataract. First, a well-designed and structured questionnaire contents were developed for postoperative follow-up. Secondly, the intelligent voice follow-up system was deployed. The system would automatically jump to the next follow-up step according to the user’s response, and give appropriate suggestions. Finally, the data of telephone recording, call time, children’s attributes were collected and statistically analyzed. Results: From February 24 to March 15, 2020, 561 families of children with congenital cataract from Zhongshan Ophthalmic Center were recruited by using the intelligent voice follow-up system. The system completed a total of 1 154 calls, of which 561 cases received follow-up data, reaching an average effective call rate of 48.6%. Among 561 cases, 204 (36.4%) thought that the extended time of follow-up visit would affect the recovery of children, while 309 (55.1%) thought that it exerted no effect on the recovery. 360 children (64.2%) achieved good ocular recovery without complications, whereas 169 cases (30.1%) developed ocular symptoms. These include white spots in the pupil area, redness and eye secretions. Statistics of different behavior of children showed that there were 417 (74.3%) children wearing glasses, 135 (24.1%) children did not wear glasses, another 9 (1.6%) children wearing glasses were not clear, often rubbing the eyes of children were more likely to appear redness (20.4%), eye secretions (17.0%) and white spots in the pupil area (6.8%) and other adverse reactions. Conclusion: The intelligent voice follow-up system shows great application potential in clinical follow-up, which can be employed as a new service mode of intelligent medical treatment.
小儿眼病专题

早产儿视网膜病变患儿治疗后屈光状态的改变

Changes of refractive statues in infants with retinopathy ofprematurity after different treatments

:774-779
 
目的:研究早产儿视网膜病变患儿经不同治疗措施后屈光状态的改变。方法:将72例(127眼)早产儿视网膜病变患儿按治疗方式分为3组:激光光凝组、注药(抗血管内皮生长因子药物)组和自然消退组。并于治疗前,治疗后1、4、7、12个月对其进行睫状肌麻痹检影验光,对比分析3组的球镜和等效球镜的差异。结果:在治疗后1、4、7及12个月,三组患儿的球镜度和等效球镜度的差异有统计学意义(P<0.05):注药组的球镜和等效球镜小于自然退化组及激光组(均P0.05)。治疗后12个月时激光光凝组、注药组和自然消退组近视发生率分别是2.4%、7.8%和2.0%,差异无统计学意义(P=0.356)。结论:经不同治疗措施的ROP患儿近视发生率无明显差异,但经玻璃体腔注射抗VEGF药物的ROP患儿正视化进程更快。
Objective: To observe the changes of refractive statues in infants with retinopathy of prematurity retinopathyof prematurity (ROP) after different treatments. Methods: According to different treatment methods, 72 cases(127 eyes) of infants with ROP were divided into 3 groups: laser photocoagulation group, intravitreal injectionof anti-vascular endothelial growth factor (VEGF) drugs group and natural regression group. Their sphere andspherical equivalent were measured by retinoscopy optometrist after the ciliary muscles paralyzed. The data beforetreatments and 1, 4, 7 and 12 months after treatments were recorded and analyzed. Results: The differences ofsphere and spherical equivalent among three groups were statistically significant: intravitreal injection of VEGFdrugs group was lower than natural regression group and the laser photocoagulation group, but there was no significant difference between natural regression group and laser photocoagulation group. Incidence of myopiaof laser photocoagulation, intravitreal injection of VEGF drugs, natural regression group were 2.4%, 7.8%, 2.0%,which was not statistically significant. Conclusion: There was no significant difference about the incidence rate ofmyopia among the three groups, but the emmetropization in infants with ROP after intravitreal injection of anti-VEGF drugs might be faster in the future.
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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