整體護理對玻璃體切除聯合硅油填充術治療視網膜脫落患者術后視力及生活質量的影響

熊敏　藍瓊好　李敏紅　陳梅花　嚴虹　陳海圓

【摘要】 目的：探討整體護理對玻璃體切除聯合硅油填充術治療視網膜脫落患者術后視力、生活質量的影響。方法：選取2016年1月-2018年6月筆者所在科室收治的視網膜脫落患者100例，均行玻璃體切除聯合硅油填充術。按隨機數字表法分為對照組（常規護理）與觀察組（在常規護理基礎上行整體護理），每組50例。比較兩組視網膜復位情況、視力改善情況、生活質量（SF-36）評分及并發癥發生率。結果：護理6個月后，觀察組視網膜復位成功率高于對照組（P<0.05）;觀察組視力改善情況優于對照組（P<0.05）;觀察組術后高眼壓、新生血管、再脫落、感染總發生率低于對照組（P<0.05）;觀察組SF-36各項評分均高于對照組（P<0.05）。結論：對于行玻璃體切除聯合硅油填充術治療的視網膜脫落患者實施整體護理可提高視網膜復位成功率及視力，降低并發癥發生率，改善生活質量。

【關鍵詞】 整體護理 玻璃體切除 硅油填充 視網膜脫落 視力 生活質量

doi：10.14033/j.cnki.cfmr.2020.16.037 文獻標識碼 B 文章編號 1674-6805（2020）16-00-04

Effects of Holistic Nursing on Postoperative Eyesight and Quality of Life of Patients with Retinal Exfoliation Treated by Vitrectomy Combined with Silicone Oil Filling/XIONG Min， LAN Qionghao， LI Minhong， CHEN Meihua， YAN Hong， CHEN Haiyuan. //Chinese and Foreign Medical Research， 2020， 18（16）： -96

[Abstract] Objective： To investigate the effects of holistic nursing on postoperative eyesight and quality of life of patients with retinal exfoliation treated by vitrectomy combined with silicone oil filling. Method： A total of 100 patients with retinal exfoliation admitted to our department from January 2016 to June 2018 were selected and all treated with vitrectomy and silicone oil filling. According to the random number table method， they were divided into the control group （routine nursing） and the observation group （holistic nursing on the basis of routine nursing）， 50 cases in each group. Retinal reattachment， improvement of eyesight， quality of life （SF-36） scores and the incidence of complications were compared between the two groups. Result： After 6 months of nursing， the success rate of retinal reattachment in the observation group was higher than that of the control group （P<0.05）. The improvement of eyesight in the observation group was better than that of the control group （P<0.05）. The total incidence of high intraocular pressure， neovascularization， re-shedding and infection in the observation group was lower than that of the control group （P<0.05）. The quality of life scores in the observation group were higher than those of the control group （P<0.05）. Conclusion： For patients with retinal exfoliation treated by vitrectomy combined with silicone oil filling， the implementation of holistic nursing can improve the success rate of retinal reattachment and eyesight， reduce the incidence of complications and improve the quality of life.

[Key words] Holistic nursing Vitrectomy Silicone oil filling Retinal exfoliation Eyesight Quality of life

First-authors address： Zhaoqing First Peoples Hospital， Zhaoqing 526040， China

視網膜脫落為眼科多發疾病，病因多樣，可引發視網膜變性、萎縮，甚至造成視力永久性損傷[1-2]。治療本病的常用方法為玻璃體切除聯合硅油填充術，臨床效果較好[3]。但術后并發癥較多，甚至可出現無光感，嚴重影響患者預后及日常生活[4-7]。術后無光感與術后體位、周圍環境具有明顯相關性，而術后的優質護理是改善預后的重要保證[8]。常規護理是針對術后體位、并發癥等采取的一系列措施，但具體實施步驟間的關聯性較差，對改善患者術后眼壓、視力等效果不顯著。整體護理是以現代理念為基礎，以護理程序為結構，以患者為核心而構建的完整的、系統的護理措施，已廣泛應用于臨床中[9]。但關于整體護理應用于視網膜脫落患者術后的臨床研究較少。因此，本文選取100例行玻璃體切除聯合硅油填充術治療的視網膜脫落患者為研究對象，探討術后實施整體護理的臨床價值，報道如下。……