表面麻醉下行早产儿视网膜病变激光光凝手术患儿的围手术期护理配合

发布时间：2018-05-04 22:09

本文选题：表面麻醉 + 早产儿　；参考：《护理实践与研究》2016年16期

【摘要】：目的:探讨表面麻醉下对早产儿视网膜病变(ROP)的患儿行视网膜激光光凝手术的围手术期护理配合,以便提高手术的安全性。方法:选取2013年10月~2015年1月间在我科行表面麻醉下视网膜激光光凝术的19例ROP患儿为研究对象,对患儿实施围手术期护理:(1)术前对家长进行健康宣教及对患儿进行病情评估,做好手术前患者的准备(清洁结膜囊、药物散瞳、开通静脉通道等)和手术器械准备。(2)术中与医师密切配合,采用合适的方法限制患儿的头部和躯体运动,用心电及血氧饱和度监护仪对患儿生命体征进行监测,及时发现患儿的眼心反射、呼吸心率异常波动、缺氧以及因疼痛所致的应激反应等异常情况,并给予相应处理,同时对患儿的过度哭闹进行干预。(3)术后重点观察患儿在激光光凝术后有无全身和眼部不良反应发生,指导合理喂养,制定随访计划并书面告知家长。结果:19例ROP患儿手术过程顺利,术后未见全身及眼部不良反应,复查视网膜激光斑稳定,未见病变范围扩大。结论:ROP患儿在表面麻醉下行激光光凝术时,护士应在围手术期给予积极有效、熟练准确的护理配合,同时在手术中和手术后密切观察患儿的全身情况变化,避免不良反应发生,保障手术的安全和成功。
[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.
【作者单位】：昆明医科大学附属儿童医院眼科;
【分类号】：R472

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