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[摘 要] 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。
Abstract 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. After 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
论著
目的: 探讨儿童双目视力筛查仪在先天性白内障中的应用。 方法: 本文为回顾性分析,选择 2017 年 7 月 至 2018 年 5 月在厦门市儿童医院眼科的 3 个月至 2 岁婴幼儿 336 例(672眼),均由2个固定的医生分别采用小瞳孔红光反射及儿童双目视力筛查仪检查,同时详细记录病史资料。所有患儿均给予裂隙灯检查、复方托品卡胺散瞳后行眼底检查,对眼底无法窥入的者必要时给予眼部B超检查或眼部MRI检查,以排除眼底病变。结果:依据2009年出版的第5版《Harley’s小儿眼科学》的先天性白内障临床分类方法,本组病例中先天性白内障的类型依次为皮质(核)白内障2 7例(35眼),其中胚胎核2例( 4眼),板层2 3例(29眼),核性2例( 2眼);囊膜性白内障1 9例(28眼),缝合性白内障2例( 4眼),极性白内障3例( 6眼),全白内障2例( 3眼)。儿童双目视力筛查仪筛查出先天性白内障的灵敏度为81.58%,特异度为79.87%,诊断符合率为80.06%;红光反射筛查的先天性白内障的灵敏度为51.32%,特异度为69.97%,诊断符合率为67.86%;两组结果比较均有统计学意义。儿童双目视力筛查仪对皮质(核)性白内障筛查率为97.14%,而红光反射的筛查率为37.14%,结果比较具有统计学意义。结论:儿童双目视力筛查仪在先天性白内障筛查中,具有低漏诊率和误诊率,较高的诊断一致性的优势,尤其对皮质(核)性白内障有高的检出率,将有利于在日常儿童眼保健的辅助筛查工作中,及早发现先天性白内障患儿。
Objective: To explore the application of children’s binocular vision screening instrument in screening congenital cataract. Methods: This was a retrospective analysis of 336 infants aged 3 months to 2 years (672 eyes) who were admitted to the Ophthalmology Department of Xiamen Children's Hospital from July 2017 to May 2018. They were examined by two fixed doctors with the pupil red light reflex and binocular vision screening instrument, and the medical history was recorded in details. All the children received slit lamp examination, compound tropicamide mydriasis and fundus examination. If necessary, the children who could not see fundus were given with B-ultrasonic examination or MRI examination. Results: According to the clinical classification of congenital cataracts published in the 5th edition of Harley’s pediatric ophthalmology in 2009, In this group, there were 27 cases (35 eyes) of congenital cataract, including 2 cases (4 eyes) of embryonic nucleus, 23 cases (29 eyes) of lamellar layer, 2 cases (2 eyes) of nuclear cataract, 19 cases (28 eyes) of capsular cataract, 2 cases (4 eyes) of suture cataract, 3 cases (6 eyes) of polar cataract and 2 cases (3 eyes) of total cataract. The sensitivity of children’s binocular vision screening instrument screening congenital cataract was 81.58%, the specificity was 79.87%, and the diagnostic coincidence rate was 80.06%; the sensitivity of red reflection screening congenital cataract was 51.32%, the specificity was 69.97%, and the diagnostic coincidence rate was 67.86%; the results of the two groups were statistically significant. The screening rate of children's binocular vision screening instrument for cortical (nuclear) cataract was 97.14%, while that of red reflex was 37.14%. The results were statistically significant. Conclusion: In the screening of congenital cataract, the binocular vision screening instrument for children has the advantages of low missed diagnosis rate, high misdiagnosis rate and high diagnostic consistency, especially for cortical (nuclear) cataract. It is helpful to find the congenital cataract early in the auxiliary screening of children’cares eye health