發(fā)布時(shí)間：2018-05-04 22:09

  本文選題：表面麻醉 + 早產(chǎn)兒　； 參考：《護(hù)理實(shí)踐與研究》2016年16期

【摘要】：目的:探討表面麻醉下對早產(chǎn)兒視網(wǎng)膜病變(ROP)的患兒行視網(wǎng)膜激光光凝手術(shù)的圍手術(shù)期護(hù)理配合,以便提高手術(shù)的安全性。方法:選取2013年10月~2015年1月間在我科行表面麻醉下視網(wǎng)膜激光光凝術(shù)的19例ROP患兒為研究對象,對患兒實(shí)施圍手術(shù)期護(hù)理:(1)術(shù)前對家長進(jìn)行健康宣教及對患兒進(jìn)行病情評估,做好手術(shù)前患者的準(zhǔn)備(清潔結(jié)膜囊、藥物散瞳、開通靜脈通道等)和手術(shù)器械準(zhǔn)備。(2)術(shù)中與醫(yī)師密切配合,采用合適的方法限制患兒的頭部和軀體運(yùn)動(dòng),用心電及血氧飽和度監(jiān)護(hù)儀對患兒生命體征進(jìn)行監(jiān)測,及時(shí)發(fā)現(xiàn)患兒的眼心反射、呼吸心率異常波動(dòng)、缺氧以及因疼痛所致的應(yīng)激反應(yīng)等異常情況,并給予相應(yīng)處理,同時(shí)對患兒的過度哭鬧進(jìn)行干預(yù)。(3)術(shù)后重點(diǎn)觀察患兒在激光光凝術(shù)后有無全身和眼部不良反應(yīng)發(fā)生,指導(dǎo)合理喂養(yǎng),制定隨訪計(jì)劃并書面告知家長。結(jié)果:19例ROP患兒手術(shù)過程順利,術(shù)后未見全身及眼部不良反應(yīng),復(fù)查視網(wǎng)膜激光斑穩(wěn)定,未見病變范圍擴(kuò)大。結(jié)論:ROP患兒在表面麻醉下行激光光凝術(shù)時(shí),護(hù)士應(yīng)在圍手術(shù)期給予積極有效、熟練準(zhǔn)確的護(hù)理配合,同時(shí)在手術(shù)中和手術(shù)后密切觀察患兒的全身情況變化,避免不良反應(yīng)發(fā)生,保障手術(shù)的安全和成功。
[Abstract]:Objective: to explore the perioperative nursing cooperation of retinal laser photocoagulation in children with retinopathy of premature infants under surface anesthesia in order to improve the safety of the operation. Methods: from October 2013 to January 2015, 19 children with ROP undergoing retinal laser photocoagulation under surface anesthesia were selected as the study subjects. The children were given perioperative nursing care: 1) health education was performed before operation and the condition of the children was evaluated. The preparation of patients before operation (cleaning conjunctival sac, drug dilating pupil, opening vein passage, etc.) and the preparation of surgical instruments should be done in close cooperation with the doctor, and appropriate methods should be adopted to restrict the head and body movement of the child. The patient's vital signs were monitored by electrocardiogram and blood oxygen saturation monitor, and the abnormal conditions such as eye and heart reflex, abnormal fluctuation of respiratory heart rate, hypoxia and stress reaction caused by pain were found in time, and the corresponding treatment was given. At the same time, intervention of excessive crying in children.) after laser photocoagulation, focus on observing the occurrence of systemic and ocular adverse reactions after laser photocoagulation, guiding reasonable feeding, making follow-up plan and informing parents in writing. Results the operation process of 19 cases with ROP was smooth. There were no systemic or ocular adverse reactions after operation. The retina laser spot was stable and the range of lesion was not enlarged. Conclusion when performing laser photocoagulation under superficial anesthesia, nurses should give effective, skillful and accurate nursing cooperation during the perioperative period, and closely observe the changes of the children's whole body during and after operation to avoid adverse reactions. To ensure the safety and success of the operation.
【作者單位】： 昆明醫(yī)科大學(xué)附屬兒童醫(yī)院眼科;
【分類號】：R472

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