氟康唑前房冲洗联合延伸护理在重度真菌性角膜溃疡患者运用效果  

The effect of Fluconazole anterior chamber irrigation combined with extended care in patients with severe fungal corneal ulcer

作　　者：程灿[1] 黎明[1] Cheng Can;Li Ming(Shenzhen Eye Hospital,Shenzhen Key Laboratory of Ophthalmology,Shenzhen Eye Injury Treatment and Stem Cell Directed Differentiation Public Service Platform,Shenzhen 518040,China)

机构地区：[1]深圳市眼科医院,深圳市眼科重点实验室,深圳市眼外伤治疗与干细胞定向分化公共服务平台,广东深圳518040

出　　处：《国际护理学杂志》2019年第3期351-355,共5页international journal of nursing

基　　金：深圳市科技计划项目资助(JCYJ20170306140020487).

摘　　要：目的探讨对重度真菌性角膜溃疡患者行清创联合羊膜移植后采用氟康唑前房冲洗联合延伸护理的效果。方法选取纳入标准的90例重度真菌性角膜溃疡患者,采用随机数字表法分为两组,每组45例患者。对照组患者采用清创联合羊膜移植治疗,出院时给予出院指导,出院后定期进行电话随访;实验组患者在对照组基础上,给予氟康唑前房冲洗联合延伸护理。6个月后,比较两组患者遵医行为、治疗疗效和并发症发生情况。结果实验组患者治疗总有效率为90.00%明显高于对照组患者52.50%,差异有统计学意义(P<0.01);实验组患者遵医行为明显高于对照组患者,差异有统计学意义(P<0.05);实验组角膜基质水肿、上皮下雾状混浊形成、药物毒性角膜炎等并发症发生率明显低于对照组患者,差异有统计学意义(P<0.01)。结论对重度真菌性角膜溃疡患者术后运用氟康唑注射液对前房进行冲洗,提高了患眼房水中的抗真菌药物的浓度,从而提高了抗真菌感染效果。通过为患者提供延伸护理,密切了护患关系,提高了患者遵医行为和护理配合,确保了治疗整体效果,降低了并发症的发生率,保障患者安全。Objective To investigate the effect of fluconazole anterior chamber irrigation combined with extended nursing on severe fungal corneal ulcer patients after debridement combined with amniotic membrane transplantation. Methods A total of 90 patients with severe fungal corneal ulcer who were included in the inclusion criteria were divided into two groups by random number table method, 45 patients in each group.Patients in the control group were treated with debridement combined with amniotic membrane transplantation.Discharge guidance was given at discharge, and regular telephone follow-up was conducted after discharge.On the basis of the control group, the patients in the experimental group were given fluconazole anterior chamber irrigation combined with extended care. Six months later, compliance behavior, therapeutic efficacy and complications were compared between the two groups. Results The total effective rate of treatment in the experimental group was 90.00%, which was significantly higher than that in the control group's 52.50%, and the difference was statistically significant(P<0.01). Compliance behavior of patients in the experimental group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05). The incidence of complications such as corneal stromal edema, subepithelial fog formation, drug toxic keratitis was significantly lower in the experimental group than in the control group, and the difference was statistically significant(P<0.01). Conclusions In patients with severe fungal corneal ulcer, fluconazole injection was used to flush the anterior chamber after surgery, and the concentration of antifungal drugs in the aqueous chamber of the affected eye was increased, thus improving the effect of antifungal infection.By providing extended care for patients, the relationship between nurses and patients was strengthened, the patient compliance behavior and nursing cooperation were improved, the overall effect of treatment was ensured, the incidence of

关 键 词：角膜溃疡 真菌 氟康唑 治疗疗效 延伸护理 

分 类 号：R473.77[医药卫生—护理学]