随着科学技术的提高、手术方式的改进,角膜屈光手术成为治疗近视的主要方式。角膜屈光手术后角膜形态及生物力学的变化对于尽早发现术后相关并发症及术后长期稳定性具有重要意义,不同的术式及术后不同的恢复阶段角膜表面非球面参数及生物力学指标的变化存在一定差异,明确其变化的原因及机制可对临床研究提供一定的参考。
With the improvement of science and technology and the improvement of surgical methods, corneal refractive surgery has become the main way to treat myopia. The changes of corneal morphology and biomechanics after corneal refractive surgery are of great significance for early detection of postoperative complications and also affect the long-term stability after corneal refractive surgery. There are some differences in the changes of aspheric parameters and biomechanical properties in different surgical procedures and different postoperative recovery stages. Clarifying the reasons and mechanisms of these changes can provide some reference for clinical research.
目的:总结大批量白内障扶贫手术的护理安全管理经验。方法:回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况,分析其安全隐患,并在护理过程中采取相应的安全措施。术前充分评估和准备,对患者进行健康指导;术中对手术环境规范管理;指导加强术后患者的自我管理。结果:8批次共1 064例白内障摘除联合人工晶体植入术顺利完成,无1例发生术后感染。结论:建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节,做好术前的评估和准备工作,落实患者的健康教育及术后患者自我管理指导,才能确保手术顺利进行。
To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: This is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. The following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed. Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety.