后弹力层角膜内皮移植术患者围手术期护理  

Perioperative nursing of patients undergoing descemet membrane endothelial keratoplasty

作　　者：程萌 陈文莺 黄娟[1] Cheng Meng;Chen Wenying;Huang Juan(Department of Ophthalmology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,湖北武汉430030

出　　处：《护理学杂志》2024年第14期45-47,53,共4页Journal of Nursing Science

摘　　要：目的总结后弹力层角膜内皮移植术(DMEK)患者围手术期护理经验。方法对18例(18眼)内皮功能失代偿患者实施DMEK,给予充分的围手术期护理及改善术后并发症的专科护理。结果18例患者手术顺利,住院时间6~12(8.17±1.82)d。14例在术后2 h出现高眼压,经放掉部分前房气体解除瞳孔阻滞,利用体位护理后眼压均下降;发生部分脱位5例(27.8%),通过再次前房注气后移植片均能完全复位。术后随访3个月,随访期间移植片在位,贴附良好,无排斥反应,无内皮功能失代偿,14例患者术后1个月矫正视力大于0.5,4例患者术后1个月矫正视力在0.2~0.5。结论对DMEK患者加强围手术期护理,重视术后体位控制以及对于高眼压的处理,对于确保手术效果至关重要。Objective To summarize perioperative nursing experience for patients undergoing Descemet Membrane Endothelial Keratoplasty(DMEK).Methods Eighteen patients(18 eyes)with endothelial dysfunction underwent DMEK,they were provided sufficient perioperative care and specialized care to improve postoperative complications.Results The surgery for the 18 patients went smoothly,their length of hospitalization was 6-12(8.17±1.82)days.Fourteen patients experienced ocular hypertension 2 hours after the DMEK,and their intraocular pressure decreased after releasing part anterior chamber air and position care.Five patients(27.8%)suffered from partial detachment of the donor tissue after surgery,and they all completely restored after anterior chamber air reinjection.During 3 months of follow-up,the graft was in place and attached well,without rejection or endothelial dysfunction compensation.At one month after the DMEK,14 patients had a best-corrected visual acuity of 0.5 or better,and the other 4 patients reached 0.2-0.5.Conclusion It is significant to strengthen perioperative nursing,pay attention to postoperative position control and ocular hypertension management for patients undergoing DMEK,so as to ensure surgery effect.

关 键 词：角膜内皮病变 角膜移植 后弹力层角膜内皮移植术 移植片脱位 高眼压 排斥反应 术后体位 眼科护理 

分 类 号：R473.77[医药卫生—护理学]