目的：探讨老年性糖尿病性白内障患者治疗及延续护理的措施。

方法：对2014年1月～2014年12月142例老年性糖尿病性白内障患者随机平均分为A组和B组，A组接受常规的出院指导；B组接受常规的出院指导及加强延续护理，根据老年性糖尿病性白内障患者 的具体情况制定护理措施 (眼部的护理、用药指导、饮食护理、心理护理、自我监测指导、定期随访及复查等内容)，并进行跟踪处理。

结果：实施延续护理一年后的患者，体重、空腹血糖、餐后2 h血糖与未实施延续护理的患者相比，差异有显著意义 (P＜0.05)。

结论：护士对老年性糖尿病性白内障患者及家属进行用眼和糖尿病相关的知识宣教、针对性的心理护理、药物治疗护理及日常生活指导等，老年性糖尿病性白内障患者的遵医率提高，减少了因疾病而对生活工作的影响，生活质量有不同程度的提高。

Purpose: To explore the treatment and continuing nursing of patients diagnosed with senile and diabetic cataract．

Methods: In total, 142 patients diagnosed with senile and diabetic cataract admitted to Zhongshan Ophthalmic Center from January to December 2014 were randomly assigned into groups A and B. In group A, patients received conventional instruction after discharge, and those in group B additionally received continuing nursing care after discharge including ocular nursing, use of anti-diabetic drugs, psychological nursing,  diet nursing, self-monitoring guidance,  re-examination and regular follow-up according to the patients’ conditions．

Results: After one year of continuing nursing care, visual acuity of patients in group B was increased without complications. Body mass index, the fasting and 2h postprandial plasma glucose,  and the systolic and diastolic blood pressure were decreased significantly compared with those in group A (all P＜0．05)．

Conclusion: Continuing nursing care, including knowledge education related to ocular use and diabetes mellitus, targeted psychological nursing,  medication nursing and daily life guidance,  play a pivotal role in enhancing the compliance rate of the patients,  reducing the influence upon work and life and enhancing the quality of life to varying extent．

目的：探讨人文关怀护理对提高眼科专科病房护理质量及病人满意度的效果。

方法：建立人文关怀护理模式，优化环境，细化工作流程，注重护士人文关怀技能的培养，应用多元化的宣教工具，实施全程、连续、无缝隙的责任制护理。

结果：人文关怀护理措施落实，护士沟通能力提高，转变过去的被动服务为主动服务，护理的质量及患者满意度明显提高，零差错，零投诉，患者满意度为99％。

结论：将人文关怀护理体现在临床护理工作中才能给患者提供高品质的护理。

Purpose：To discuss the role of humanistic nursing care in improving the nursing quality and patients' degree of satisfaction in ophthalmic ward．

Methods：A mode of humanistic nursing care was established，hospital environment was improved and work flow was arranged in details．Nurses received professional training of humanistic care skills．By using multiple educational approaches，nursing care with responsibility system can be delivered in a continuous and seamless manner．

Results：The measures of humanistic nursing care were fully implemented．The nurses'  communication ability was improved and the nurses worked more actively. The quality of nursing and patients'  degree of satisfaction (99％) were equally significantly improved．No mistake occurred and no complaint was received from the patients．

Conclusion：Proper application of humanistic care in clinical nursing provides high-quality nursing for patients．

目的：探讨完善泪道成形+义管植入日间手术患者的延续性护理对预防义管意外脱管的重要作用。方法：收集我科2016年1月至12月实施了标准延续性护理的泪道成形+义管植入日间手术患者的意外脱管情况。结果：泪道成形+义管植入日间手术患者随访期间没有发生医源性脱管，有9例9眼带管期间在院外发生脱管，意外脱管率为2.6%。结论：做好泪道成形+义管植入日间手术患者的延续性护理，有效降低义管意外脱出率，有利于患者康复。

Objective: To explore the important role of continuous nursing of the patients with day surgery of lacrimal duct forming combined tube implantation in the aspect of accident prevention to take off the tube. Methods: The information of the patients from Jan. to Dec. 2016 with accident the tube’s takeoff after carrying out the standard continuity of care were collected. Results: There was no iatrogenic but 9 eyes of 9 patients accidentally take off the tube during follow-up period. Accidental decannulation rate was 2.6%. Conclusion: Continuous care of the patients with day surgery of lacrimal duct forming combined tube implantation can effectively reduce the tube accidentally removal rate and be beneficial to patients’ recovery.

10% 水合氯醛是最常用的小儿镇静药之一，广泛应用于眼科小儿检查和治疗前。对于年龄小、不配合的患儿，如何合理、安全使用水合氯醛，提高其镇静效果，减少其并发症发生，笔者总结护理心得如下：使用前对小儿进行全身的评估和家长的准备，使用时要掌握口服或灌肠的操作技巧，使用后要注意观察小儿的全身反应、用药效果和做好家长的宣教。

10% chloral hydrate is one of the most commonly used pediatric sedatives, which is widely used before ophthalmic pediatric examination and treatment. For young uncooperative children, how to use chloral hydrate reasonably and safely to improve their sedative effect and reduce the occurrence of complications, we summarized the nursing experiences, including evaluating child’s whole body and the preparation of parents before its use; mastering operative techniques of oral or enema route of admission in its use; paying attention to observe the child's systemic response and efficacy of drug, and patient education

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.

      总结32例飞秒激光辅助角膜移植术患者的护理，认为做好心理护理、术前完善眼部检查和做好充分的准备，术后严密观察敷料、眼压和角膜植片的情况，做好特殊体位和角膜接触镜的护理，并做好出院指导是提高手术的成功率及预防并发症的关键。

This paper summarized the nursing care of 32 patients received femtosecond laser assisted corneal transplantation. The key points to increase the success rate of surgery and prevent complications were psychological nursing, preoperative examinations and fully prepared, postoperative observation of dressing, intraocular pressure and corneal glass, care of special position and corneal contact lens, and discharge guidance.

目的：探讨利用微信平台在有晶体眼人工晶体(implantable collamer lens，ICL)植入术后并发性白内障患者延续性护理的应用效果。方法：对13例(16眼)ICL植入术后并发性白内障患者利用微信平台随访和延续性护理，观察患者术前和术后1个月的护理满意度的自身对照。结果：13例患者(16眼)手术均顺利完成，术后均无出现并发症，术后视力均较术前有所提高，术后患者的护理满意度评分高于术前，差异有统计学意义(P<0.05)。结论：利用微信平台进行随访和延续性护理，可以提高患者护理满意度，是应用于ICL植入术后并发性白内障患者的有效护理方法。

Objective: To explore the application effect of WeChat platform in continuous nursing care for patients with complicated cataract after implantable collamer lens (ICL) implantation. Methods: Thirteen patients (16 eyes) with complicated cataracts after ICL implantation were followed up and continued nursing on the WeChat platform, then the self-control of the patients’ satisfaction on nursing before and one month after surgery was observed. Results: A total of 13 patients’ operation (16 eyes) went well, and they had no postoperative complications. The visual acuity of the patients was improved after operation compared with that of before operation, and the nursing satisfaction score of patients after operation was higher than that of before operation; the difference was statistically significant (P<0.05). Conclusion: Using WeChat platform for follow-up and continuous nursing can improve patients' nursing satisfaction, which was an effective nursing method for patients with complicated cataract after ICL implantation.

目的：探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法：采用便利抽样法抽取行角膜移植日间手术的173例患者，采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果：角膜移植日间术后患者延续护理需求得分为88.13±15.55，其中，对疾病相关知识的需求得分最高，为4.39±0.66，对心理护理的需求得分最低，为2.72±1.18；在延续护理实施方式方面，74.6%患者倾向于电话随访，只有5.8%倾向于上门服务；在影响因素方面，婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论：角膜移植日间术后患者的延续护理需求较高，应根据患者延续护理需求及影响因素进行个性化指导，以提高角膜移植手术的成功率和减少并发症的发生。

Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.

目的：在麻醉监测管理(monitored anesthesia care，MAC)中，通过与咪唑安定比较，观察右美托咪 定在玻璃体视网膜手术中应用的效果、安全性，探讨其应用可行性。方法：将择期玻璃体视网膜 手术患者40例随机双盲分入咪唑安定组(M组)和右美托咪定组(D组)。每组20例，两组患者均行球 后神经阻滞麻醉，连接脑电双频指数(bispectral index，BIS)监测仪监测并维持BIS值在70~90间， 观察和比较麻醉手术中及复苏期的平均动脉压(mean arterial pressure，MAP)、心率(heart rate， HR)、呼吸频率(respiratory rate，RR)、脉搏氧饱和度(oxygen saturation，SpO2)、Ramsay镇静评 分、疼痛数字评分法(Numerical Rating Scale，NRS疼痛评分)、手术医生和患者麻醉效果评分及不 良反应的差异。结果：与麻醉前比较，手术期D组用药后10 min内的心率、血压下降差异有统计学 意义(P<0.05)，且用药后10 min内D组心率下降幅度较M组更大(P<0.05)。在手术期和复苏期，D组 的NRS疼痛评分均显著低于M组且差异有统计学意义(均P<0.001)，而两组的Ramsay镇静评分差异 无统计学意义(P>0.05)。D组手术期患者的体动发生率和羟考酮使用率显著低于M组(均P<0.05)。 手术医生和患者的麻醉效果评分D组显著高于M组(均P<0.001)。结论：右美托咪定用于玻璃体视 网膜手术，较咪唑安定镇痛效果好且不良反应少，麻醉效果更好。

Objective: The aim of this study was to compare the efficacy and safety of dexmedetomidine versus midazolam for the monitored anesthesia care (MAC) management of patients undergoing vitreoretinal surgery. Methods: Forty patients undergoing selective vitreoretinal surgery were double-blind and randomly dividedinto midazolam group (group M) and dexmedetomidine group (group D), each group had 20 patients. Patients in both groups were anesthetized with posterior bulbous nerve block. Bispectral index (BIS) monitor was connected and the BIS value was maintained between 70 and 90. The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), Ramsay sedation score, numerical rating scale (NRS), surgeon’s and patient’s anesthesia effect score and adverse reactions were recorded during anesthesia and recovery period. Results: Compared with the data of pre-anesthesia, there were statistical differences of the decrease of HR and MAP in group D within the 10 minutes after medication (P<0.05), and the decrease of HR in group D was greater than that in group M (P<0.05). The NRS pain score in group D was significantly lower than that in group M with statistical significance (P<0.001) during the operation and resuscitation, while there was no significant difference in Ramsay sedation score between the two groups during the operation and resuscitation (P>0.05). In terms of adverse reactions to anesthesia, the incidence of spontaneous movement and oxycodone utilization in group D were significantly lower than those in group M (P<0.05). The anesthesia effect scores of surgeons and patients in group D were significantly higher than those in group M (all P<0.001). Conclusion: Dexmedetomidine has better analgesic effect and less adverse reactions than midazolam in vitreoretinal surgery.

目的：了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容，为医护人员制订居家照护支持计划提供依据。方法：采用描述性质性研究方法，于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈，采用归纳式内容分析法对访谈资料进行分析。结果：重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变；护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论：重度视力损伤和盲患者居家照护存在诸多的护理问题及需求，患者希望得到多维度相关知识和多渠道医疗咨询，医院、社区应该高度重视此类患者，同时给予相应的指导和帮助，从而提高患者的居家生活质量。

Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.