睑板腺功能障碍可导致眼表微环境失衡，眼部不适及视功能障碍，深刻影响着患者的视觉生活质量。睑板腺按摩作为一种通过机械挤压睑板腺疏通睑板腺开口，排出异常睑酯的治疗手段，目前已被广泛应用于临床干眼患者，成为睑板腺功能障碍最常见的物理治疗方法。但由于睑板腺按摩的操作手法多样，不同医疗机构所积累的操作经验也不尽相同，导致在治疗过程中存在较多潜在风险，若操作不当，可造成眼部感染、眼睑红肿、结膜水肿出血，甚至角膜损伤。因此，制定标准化的操作流程，规范睑板腺按摩治疗非常重要。然而，目前尚缺乏全面、系统化且规范化的睑板腺按摩操作的临床实践指导。鉴于此，中山大学中山眼科中心联合全国19所医疗机构进行反复修订，于2023年12月17日在全国团体标准信息平台发布《睑板腺按摩操作流程》的团体标准。文章对该团体标准进行深度解读，以更好指导临床工作。
Meibomian gland dysfunction (MGD) can lead to an imbalance in the ocular surface microenvironment, eye discomfortable, and visual impairment, thereby profoundly affecting the visual quality of life of patients. Meibomian gland massage is now widely used in clinical patients, serving as the most prevalent physical therapy for MGD. The mechanism of meibomian gland massage is to open the meibomian gland opening by squeezing the meibomian gland and expel abnormal eyelid esters. However, due to the diverse techniques used in meibomian gland massage and the varying levels of operational experience accumulated by different medical institutions, there are many potential risks in treatment process. If medical staff operate improperly, it can cause eye infections, eyelid redness and swelling, conjunctival edema and bleeding, and even corneal damage. Therefore, it is crucial to establish the standardized procedure of meibomian gland massage therapy. Yet, there is currently lack of comprehensive, systematic, and standardized clinical practice guidance. Thus, the Zhongshan Ophthalmic Center, Sun Yat-sen University, in collaboration with 19 medical institutions across the country, has released the group standard for Operation Procedure of Meibomian Gland Massage on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group standard to guide clinical work better.
睑板腺功能障碍(meibomian gland dysfunction, MGD)是一种慢性弥漫性睑板腺疾病，可引起眼红、眼干、异物感等眼部不适，影响患者的眼健康及生活质量。强脉冲光(intense pulsed light, IPL)作为一种新兴有效的物理治疗方法，目前已广泛应用于治疗MGD及其他常见的眼表疾病，如蠕形螨性睑缘炎、睑缘炎相关角结膜病变、复发性睑板腺囊肿等。在IPL临床应用中，规范的操作是保障治疗有效性与安全性的关键。为更好指导和规范临床眼科医护人员的IPL治疗操作，由中山大学中山眼科中心牵头，联合全国19所医疗机构，经过多次修订，于2023年12月17日在全国团体标准信息平台发布了《强脉冲光治疗睑板腺功能障碍操作流程》的团体标准。文章旨在对该团体标准进行深度解读，详细阐述操作中的重点、难点与操作细节，以更好地指导临床工作。
Meibomian gland dysfunction is a chronic diffuse meibomian gland disease that can cause eye discomfort such as redness, dryness, and foreign body sensation in patients, and influence their eye health and quality of life. Intense pulsed light (IPL), as an effective physical therapy for meibomian gland dysfunction, is being used to treat meibomian gland dysfunction and related diseases widely, such as demodex blepharitis, keratoconjunctivitis, recurrent meibomian gland cysts and so on.. In the clinical application of IPL, standardized procedures are key to ensuring the effectiveness and safety of treatment. In order to better guide and standardize the IPL treatment operation of clinical ophthalmic medical workers, led by the Zhongshan Ophthalmic Center, Sun Yat-sen University, and joined with 19 medical institutions across the country, after multiple revisions, the group standard " Operation Procedure of Intense Pulsed Light for Meibomian Gland Dysfunction" was released on the National Group Standard Information Platform on December 17, 2023. This article aims to provide an in-depth interpretation of the group's standards, detailing the key points, difficulties, and operational details of specific operations, in order to better guide clinical work.
Objective: To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.
Methods: Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included. Four English databases and three Chinese databases were searched from inception to Jan. 2022. Two reviewers independently performed data extraction and risk of bias assessments. The Cochrane Collaboration tool was used to assess the risk of bias. Meta-analysis was performed using Review Manager 5.3. The outcomes were overall anxiety, blood pressure, heart rate and pain.
Results: Atotal of 11 trials with 1,469 participants were included in the meta-analysis. Compared to standard care, music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery (p<0.05). The results also suggested that music therapy produced a signifcant improvement in blood pressure (p<0.05) and heart rate (p<0.05). The visual analogue scale (VAS) showed that music therapy signifcantly reduced pain compared to standard care (p<0.05).
Conclusions: This meta-analysis provided evidence that music therapy has an obvious effect on relieving anxiety levels, while it is also more effective in alleviating pain and improving physiological responses than standard care alone. Our fndings may provide accurate evidence-based guidance for the clinical implementation of music therapy. In the future, more high-quality studies are required for verifying these results.
Objective: To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.
Methods: Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included. Four English databases and three Chinese databases were searched from inception to Jan. 2022. Two reviewers independently performed data extraction and risk of bias assessments. The Cochrane Collaboration tool was used to assess the risk of bias. Meta-analysis was performed using Review Manager 5.3. The outcomes were overall anxiety, blood pressure, heart rate and pain.
Results: Atotal of 11 trials with 1,469 participants were included in the meta-analysis. Compared to standard care, music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery (p<0.05). The results also suggested that music therapy produced a signifcant improvement in blood pressure (p<0.05) and heart rate (p<0.05). The visual analogue scale (VAS) showed that music therapy signifcantly reduced pain compared to standard care (p<0.05).
Conclusions: This meta-analysis provided evidence that music therapy has an obvious efect on relieving anxiety levels, while it is also more effective in alleviating pain and improving physiological responses than standard care alone. Our fndings may provide accurate evidence-based guidance for the clinical implementation of music therapy. In the future, more high-quality studies are required for verifying these results.
目的：构建、实施并评价眼科日间手术健康教育模式的有效性。方法：依托信息化手段和Teach-back法，构建眼科日间手术健康教育模式。选取2020年1月至2021年5月中山大学中山眼科中心日间手术患者177例为研究对象，采用历史对照研究法，对照组97例，观察组80例。对照组予常规健康宣教，观察组予基于信息化和Teach-back法的健康教育模式，比较2组患者健康教育知识掌握情况和围手术期护理满意度。结果：观察组健康教育知识自评得分和实际掌握程度得分均显著高于对照组(P<0.05)；2组患者体位护理知识得分和护理工作满意度得分之间的差异无统计学意义(P>0.05)。结论：构建基于信息化和Teach-back法的健康教育模式可以提高眼科日间手术患者健康教育知识掌握度，但对于患者体位护理知识掌握程度和护理工作满意度方面的影响还需要进一步研究。
Objective: To construct, implement and evaluate the effectiveness of the health education model for ophthalmic day surgery. Methods: The health education model for ophthalmic day surgery was constructed relying on information-oriented means and Teach-back method. A total of 177 patients with day surgery in Zhongshan Ophthalmic Center from January 2020 to May 2021 were selected as the research subjects and divided into a control group (n=97) and an intervention group (n=80) by historical comparative study. The intervention group was carried out with the health education model based on information-oriented means and Teach-back method, while the control group received the routine health education. The health education knowledge and perioperative nursing satisfaction were compared between the 2 groups. Results: The scores of self-evaluation and nurse evaluation for health education knowledge in the intervention group were significantly higher than those in the control group (P<0.05). There was no significant difference in body position nursing knowledge score and nursing satisfaction score between the 2 groups (P>0.05). Conclusion: The health education model based on information oriented means and Teach-back method can improve the health education knowledge level of patients with ophthalmic day care surgery. In the meanwhile, further studies will be needed to explore the effects on patients in body position nursing knowledge and nursing satisfaction.
目的：通过中山大学中山眼科中心眼科互联网护理咨询门诊建设与运营经验，对互联网专科护理服务模式及效果进行分析，为眼科互联网+护理服务提供参考。方法：依托医院优质资源，成立眼科互联网护理咨询门诊；根据眼科患者的实际需求，制订互联网护理咨询门诊服务制度、工作流程，对出诊专家进行资质审核、培训与考核。收集、统计眼科互联网护理咨询门诊接诊量、患者满意度、首诊问题分类及护士职业获益感等数据。结果：2021年6月26日至12月31日累计接诊患者1266人次；接诊时间主要在08:00—22:00；咨询次数最多的问题种类是眼健康知识科普；患者对眼科互联网护理咨询门诊的总体满意度为99.52%；眼科互联网护理咨询门诊运营后，眼科护士职业获益感总分及各维度得分均有提高，差异均有统计学意义(均P<0.05)。结论：眼科互联网护理咨询门诊服务可有效满足各类人群的眼健康护理需求，患者满意度高，亦可提高眼科护理人员的职业获益感，值得进一步推广
Objective: Based on the construction and practice of Internet nurse-led clinic in our hospital, the model and effect of Internet specialized nursing service were analyzed to provide reference for Internet-based nursing service in ophthalmology. Methods: Relying on the hospital’s high-quality resources, the Internet nurse-led clinic in ophthalmology was established. According to the actual needs of ophthalmology patients, the Internet nursing consultation outpatient service system and workflow were formulated, experts’ qualification were reviewed, and training and assessment for the experts were conducted. The data on the number of outpatient visits, patients’ satisfaction, advisory questions and nurses’ perceived professional benefits were collected and analyzed. Results: From 26th June to 31st December 2021, the number of clinical reception was 1 266. The visit time is mainly between 08:00 to 22:00, the most frequently asked questions were eye health knowledge, the overall patients’ satisfaction was 99.52%, and the total score and the score of all dimensions of nurses’ perceived professional benefits were improved, with statistical significance (all P<0.05). Conclusion: Ophthalmic internet nurse-led consultation clinic can effectively meet the health care needs of all kinds of people, with high patient satisfaction, and can also improve nurses’ perceived professional benefits, which is worthy of further promotion.
