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1、·46·JournalofNursingScienceDec.2013Vo1.28No.24·手術室護理·愛惜康·論著·ETHICON~鼻腔填塞對鼻內鏡手術患者眼內壓的影響戴黎敏,朱魏,王巧桂摘要:目的觀察鼻內鏡手術患者術中眼內壓的變化,為實施科學的手術護理提供參考。方法選擇25例鼻內鏡手術患者,全麻后采用筆式眼壓計分別于全麻后5min(TO)、填塞前5min(T1)、填塞后5min(T2)、填塞后10min(T3)、填塞后15rain(T4)測量患者眼內壓,同時監(jiān)測各時間點患者平均動脈壓(MA
2、P)、·心率、氣道壓(PAw)的變化。結果患者術中TO、T1時間點眼內壓均在正常范圍,鼻腔填塞后眼內壓逐漸升高,與TO比較,T2、T3、T4時眼內壓明顯升高(均P<0.01);術中各時點MAP、HR、PAW比較,差異無統(tǒng)計學意義(均P>0.05)。結論鼻內鏡手術后隨著鼻腔填塞時間的延長患者眼內壓逐漸升高,護理人員應根據(jù)鼻腔填塞對患者眼內壓的影響規(guī)律采取適當?shù)淖o理措施,以減少視力損害發(fā)生,保障手術患者安全。關鍵詞:鼻內鏡手術;鼻腔填塞;眼內壓;護理中圖分類號:R473.76文獻標識碼:A文章編號:
3、1001~4152(2013)24—0046—02DOI:10.3870/hlxzz.2013.24.046Effectsofnasalpackingonintraocularpressureinpatientsduringendoscopicnasalsurgeryf≠DaiLimin,ZhuWei,WangQiaogui}f(DepartmentofAnesthesia,NanjingDrumTowerHospital,MedicalSchoolofNanjingUniversity,Nan
4、jing210008,China)Abstract:0bjectiveToobservethechangesofintraocularpressure(IOP)inpatientsundergoingendoscopicnasalsurgery,andtoprovidereferencesforscientificintraoperativecare.MethodsAftergeneralanesthesia,25patientsundergoingendoscopicnasalsur—gery
5、wereenrolledinthisstudy,andtheirIOPweremeasuredat5minaftergeneralanesthesia(TO)。5minbeforepacking(T1),5minafterpacking(T2),10minafterpacking(T3),and15rainafterpacking(T4)byusingaTono—pentonometer.Themeanarterialpressure(MAP),heartrates(HR),andairwayp
6、ressure(PAW)werealsorecordedateachtimepoint.ResultsThelOPmaintaineditsnormalvaluesatTOandT1,thenitelevatedgraduallywithtimeafterpackingandshowedsignificantdifferencescomparedwiththevalueatTO(P<0.01foral1).Therewerenosignificantdifferencesinthevalueso
7、fMAP,HR,PAWateachtimepoint(P>O.05foral1).ConclusionIOPincreaseswithtimeofnasalpackinginpatientsundergoingendoscopicnasalsurgery.NursesshouldprovideappropriateinterventionsbasedonlOPchangepatternstoreducepatientsvisualimpairmentandprotecttheirsafety.K
8、eywords:endoscopicnasalsurgery;nasalpacking;intraocularpressure;nursingcare圍術期視力損害是一種可導致患者視力暫時性前分級標準(AmericanSocietyofAnesthesiology,部分或全部缺失直至永久性完全失明等嚴重后果的ASA)分為I級,術前無青光眼等眼科病史,無呼吸循并發(fā)癥,全麻手術后此類并發(fā)癥發(fā)生率約為環(huán)系統(tǒng)并發(fā)癥。1/61000_j]。術中眼保護已受到臨床醫(yī)護人員的高1.2方法度重視。隨著鼻內鏡手術的