角膜移植术后白内障的围手术期护理  

Perioperative nursing for the keratoplasty patients with cataract

作　　者：张怡琳 王燕 刘文猜 王颖 王婷 

机构地区：[1]山东省眼科医院护理部,济南250021 [2]山东省眼科医院眼科病房,济南250021 [3]山东省眼科医院白内障科,济南250021

出　　处：《中华现代护理杂志》2013年第6期654-655,共2页Chinese Journal of Modern Nursing

基　　金：山东省自然科学基金青年基金（ZR2010HQ011）

摘　　要：目的探讨穿透性角膜移植术后白内障行手术治疗的护理措施。方法对15例角膜移植术后白内障的手术患者进行围手术期护理，包括术前预防感染、提前应用预防排斥药物、关注术前散瞳情况；术中注意是否有虹膜粘连、防止高眼压、减少内皮细胞损伤；术后预防排斥反应、抗炎、预防感染；出院前注意事项宣讲。结果15例患者手术后视力平均提高0.3，眼压在正常范围，术后随诊6个月内无1例角膜内皮功能失代偿及角膜植片免疫排斥反应，角膜植片均保持透明，患者满意程度高。结论角膜移植术后并发性白内障患者眼部病情复杂，手术后容易发生角膜移植免疫排斥，良好的围手术期的治疗与护理是手术成功的重要因素。Objective To explore the nursing measures of keratoplasty patients complicated with cataract during the cataract surgery stage. Methods Perioperative nursing care were performed on 15 cases with cataract after keratoplasty surgery. Preoperative care such as reducing the fear and tension, the prevention of infection, taking anti-rejection drugs in advance, paying attention to preoperative mydriatic. Intraoperative care such as preparing surgical instruments, preparing mydriatic drugs, paying attention to intraoperative iris adhesion and so on. Postoperative nursing such as preventing rejection, anti-inflammation, preventing infection, observation. And the attentions for patients were educated to patients. Results Before surgery, among 15 cases, 33.3 percent of them had mydriatic 〈 5 mm, and their intraocular pressure were normal. While after surgery, with follow up 6 months, no patients had rejection, and corneal planting piece were keep transparent, and patients＇ satisfaction were improved. Conclusions The situation of keratoplasty patients with cataract is much more complex and the rejections is incidental. And better clinical nursing is an important influencing factor of the success for surgery.

关 键 词：角膜移植 穿透性 白内障 围手术期护理 

分 类 号：R473.77[医药卫生—护理学]