改良包眼方法对斜视双眼矫正术后患者视功能相关生活质量及焦虑情绪影响的非随机对照试验

An improved eye-covering technique: its impact on postoperative vision-related quality of life and anxiety in patients undergoing bilateral strabismus surgery-a non-randomized controlled trial

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目的:探索采用一眼眼罩联合另一眼眼垫的改良包眼方式对斜视患者双眼矫正术后恢复期生活质量及焦虑情绪的影响。 方法:于2024年9—10月在中山大学中山眼科中心招募日间手术接受双眼斜视矫正术的患者80例,按入院时间单双周分为联合眼罩组和眼垫组,每组各40例。联合眼罩组在手术肌肉少的眼睛或主导眼佩戴多小孔塑料眼罩,另一眼用眼垫包眼;眼垫组采用双眼眼垫包眼。主要结局指标为术后1 d的视功能相关生活质量。次要结局指标包括术后1 d的睡眠评分、疼痛评分、球结膜充血水肿、切口外观及术后1周患者满意度。 结果:两组患者在性别、年龄、术前斜视情况和斜视手术肌肉条数等基线特征分布的差异无统计学意义(P>0.05)。联合眼罩组术后1 d视功能相关生活质量、睡眠和术后1周患者满意度均优于眼垫组,差异具有统计学意义(P<0.05)。两组患者在术后1 d疼痛程度、球结膜充血、切口外观、斜视改善程度的比较,差异无统计学意义(P>0.05);结论:斜视双眼矫正术后采用一眼眼罩联合一眼眼垫遮盖的方式,在保证术后恢复效果的同时,能够有效改善患者术后视功能相关生活质量和睡眠质量,并提升患者满意度。
Objective:To investigate the effects of a modified eye-patching technique, which combines the use of an eye shield on one eye and an eye patch on the other, on the quality of life and anxiety levels of strabismus patients during the recovery period after binocular correction surgery. Methods: A total of 80 patients who underwent bilateral strabismus correction as day surgery at our hospital between September and October 2024 were recruited for this study. Based on whether their admission week was odd or even, they were randomly assigned to two groups: the combined patching group (n=40) and the conventional patching group (n=40). In the combined patching group, patients wore a multiple-aperture plastic eye shield on the eye with fewer operated muscles or the dominant eye, while the other eye was covered with a conventional eye patch. In the conventional patching group, patients received bilateral eye patches. The primary outcome measure was vision-related quality of life on the first postoperative day. Secondary outcomes included the sleep quality score, pain score, conjunctival hyperemia and edema, incision appearance on the first postoperative day, and patient satisfaction one week after surgery. Results: There were no statistically significant differences in baseline characteristics, such as gender, age, preoperative strabismus status, or the number of operated muscles, between the two groups. Compared to the conventional patching group showed significantly better vision-related quality of life and sleep quality on the first postoperative day, as well as higher patient satisfaction one week after surgery (P< 0.05). On the first postoperative day, there were no significant differences between the two groups in pain level, conjunctival hyperemia, incision appearance, or degree of strabismus improvement (P > 0.05). Conclusions: The application of a modified eye-covering method, which combines an eye shield on one eye and an eye patch on the other, after bilateral strabismus correction surgery, can effectively enhance postoperative vision-related quality of life and sleep quality. Moreover, it can maintain recovery outcomes and increase patient satisfaction. This approach holds clinical value and is worthy of wider promotion.

飞秒激光辅助角膜内皮移植手术的护理配合

Nursing and cooperation of femtosecond laser-assisted endothelial keratoplasty

:168-172
 
目的:探讨飞秒激光辅助角膜内皮移植(endothelial keratoplasty, EK)手术的护理配合。方法:19例(19只眼)飞秒激光辅助的EK手术进行术前访视,充分的术前准备,各种仪器调试及器械的准 备,术中熟悉手术过程,指导患者配合手术并密切配合医生,做好患者术中、术后的体位管理,仪器及器械的处理。结果:19例手术均顺利完成,术中无意外发生,患者积极配合,术后视力89.5%(17/19)明显提高,眼部刺激症状消失,植片角膜内皮细胞数丢失不多。结论:飞秒激光辅助EK作为一种全新的手术技术,完善的术前准备,密切的手术配合,特殊体位护理是保证手术成功的关键。
Objective: To investigate nursing and cooperation of femtosecond laser-assisted endothelial keratoplasty (EK). Methods: Preoperative visit and adequate preoperative preparation were proceeded in 19 patients (19 eyes) underwent femtosecond laser-assisted EK, instrument commissioning and equipment preparation were performed before the surgery. We mastered the surgical procedures, guided patients for cooperating the operation, and cooperated closely with surgeon during operation. Management of intraoperative and postoperative body position were accomplished, instruments and equipment were well processed aff er operation. Results: All of the 19 cases were successfully completed without intraoperative accident, all of the patients cooperated actively. Postoperative visual acuities in 89.5% (17/19) of the patients were improved significantly, ocular irritation symptoms were disappeared, and corneal endothelial cells of the grafts were decreased slightly. Conclusion: Femtosecond laserassisted EK is a brand new surgical technology, perfect preoperative preparation, intimate operative cooperation, and management of special body position are essential for a successful operation.
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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