全身麻醉非眼部手术患者术中眼部保护规范的循证实践
摘要
<正>实施全身麻醉的患者在行非眼部手术的过程中可能会出现一些眼部并发症,其原因主要是由于麻醉导致角膜反射消失,眼内液产生减少,以及痛觉的消失[1],因此,全身麻醉手术患者术中有必要对眼部采取相应的保护措施[2]。有报道指出,全身麻醉下非眼部手术的角膜上皮损伤发生率在眼部未进行保护时为44.0%[3],眼部采用药膏保护后其发生率为2.1%[4]。通过查阅大量文献可看出,眼部保护的措
引文
[1]MALAFA M M,COLEMAN J E,BOWMAN R W,et al.Perioperative corneal abrasion:updated guidelines for prevention and management[J].Plast Reconstr Surg,2016,137(5):790-798.
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[3]BATRA Y K,BALI I M.Corneal abrasions during general anesthesia[J].Anesth Analg,1977,56:363-365.
[4]SCHIMDT P,BOGGILD-MADSEN N B.Protection of the eyes with ophthalmic ointments during general anesthesia[J].Acta Ophthalmol,1981,59:422-427.
[5]WHITE E,DAVID D B.Care of the eye during anaesthesia and intensive care[J].Anaesth Intensive Care,2007:8(9):383-386.
[6]GRIXTI A,SADRI M,WATTS M T.Corneal protection during general anesthesia for nonocular surgery[J].Ocul Surf,2013,11(2):109-118.
[7]ROBIN P N,SANDRA L D,STEPHANIE S P,et al.Johns Hopkins nursing evidence-based practice model and guidelines[M].Indiana:Sigma Theta Tau International,2007:204-207.
[8]MARTIN D P,WEINGARTEN T N,GUNN P W,et al.Performance improvement system and postoperative corneal injuries:incidence and risk factors[J].Anesthesiology,2009,111(2):320-326.
[9]LICHTER J R,MARR L B,SCHILLING D E,et al.A Department-of-Anesthesiology-based management protocol for perioperative corneal abrasions[J].Clin Ophthalmol,2015,9:1689-1695.
[10]张志慧,曾秀仪,李铭,等.新型全麻手术患者眼部保护方案及效果[J].中华现代护理杂志,2011,17(32):3860-3862.
[11]李鹏,祁成程,程月娥.不同眼部保护方法对全身麻醉术后患者发生眼部并发症的影响[J].解放军护理杂志,2012,29(9B):41-43.
[12]饶坤林,龚腊梅.医用水凝胶眼疗贴在全麻患者眼眼保护中的应用[J].齐鲁护理杂志,2013,19(18):118-119.
[13]WAN T,WANG Y,JIN X M.Corneal injury and its protection using hydro-gel patch during general anesthesia[J].Int J Ophthalmol,2014,7(6):964-967.
[14]VETTER T R,ALI N M,BOUDREAUX A M.A casecontrol study of an intraoperative corneal abrasion prevention program:holding the gains made with a continuous quality improvement effort[J].Jt Comm J Qual Patient Saf,2012,38(11):490-496.
[15]GROVER V K,KUMAR K V,SHARMA S,et al.Comparison of methods of eye protection under general anaesthesia[J].Can J Anaesth,1998,45(6):575-577.
[16]谭云燕,宁传艺,刘丽清,等.全麻下头面部手术患者眼保护方法的对比研究[J].护理实践与研究,2012,9(3):15-16.
[17]叶素芳,林平联,钟玲.头颈部手术中两种眼部保护方法应用的效果评价[J].福建医药杂志,2012,34(6):151-152.
[18]张琳娟,黎黎,吴越,等.全麻下垂体瘤手术患者两种眼睛保护方法的效果观察[J].西部医学,2014,26(10):1323-1324.
[19]黄文娟.全麻俯卧位脊柱手术患者术中眼部保护方法的研究[J].齐齐哈尔医学院学报,2014,35(22):3382-3383.
[20]刘祖国,姚勇,孙秉基,等.过敏性结膜炎的临床特点[J].中国实用眼科杂志,2004,22(9):694-697.
[21]徐小群,曹茜,包纯纯,等.金霉素眼膏联合3M眼贴膜在头面部全麻手术患者中的应用[J]..现代中西医结合杂志,2008,17(14):2217-2218.
[2]GILD W M,POSNER K L,CAPLAN R A,et al.Eye injuries associated with anesthesia[J].Anesthesiology,1992,72:204-208.
[3]BATRA Y K,BALI I M.Corneal abrasions during general anesthesia[J].Anesth Analg,1977,56:363-365.
[4]SCHIMDT P,BOGGILD-MADSEN N B.Protection of the eyes with ophthalmic ointments during general anesthesia[J].Acta Ophthalmol,1981,59:422-427.
[5]WHITE E,DAVID D B.Care of the eye during anaesthesia and intensive care[J].Anaesth Intensive Care,2007:8(9):383-386.
[6]GRIXTI A,SADRI M,WATTS M T.Corneal protection during general anesthesia for nonocular surgery[J].Ocul Surf,2013,11(2):109-118.
[7]ROBIN P N,SANDRA L D,STEPHANIE S P,et al.Johns Hopkins nursing evidence-based practice model and guidelines[M].Indiana:Sigma Theta Tau International,2007:204-207.
[8]MARTIN D P,WEINGARTEN T N,GUNN P W,et al.Performance improvement system and postoperative corneal injuries:incidence and risk factors[J].Anesthesiology,2009,111(2):320-326.
[9]LICHTER J R,MARR L B,SCHILLING D E,et al.A Department-of-Anesthesiology-based management protocol for perioperative corneal abrasions[J].Clin Ophthalmol,2015,9:1689-1695.
[10]张志慧,曾秀仪,李铭,等.新型全麻手术患者眼部保护方案及效果[J].中华现代护理杂志,2011,17(32):3860-3862.
[11]李鹏,祁成程,程月娥.不同眼部保护方法对全身麻醉术后患者发生眼部并发症的影响[J].解放军护理杂志,2012,29(9B):41-43.
[12]饶坤林,龚腊梅.医用水凝胶眼疗贴在全麻患者眼眼保护中的应用[J].齐鲁护理杂志,2013,19(18):118-119.
[13]WAN T,WANG Y,JIN X M.Corneal injury and its protection using hydro-gel patch during general anesthesia[J].Int J Ophthalmol,2014,7(6):964-967.
[14]VETTER T R,ALI N M,BOUDREAUX A M.A casecontrol study of an intraoperative corneal abrasion prevention program:holding the gains made with a continuous quality improvement effort[J].Jt Comm J Qual Patient Saf,2012,38(11):490-496.
[15]GROVER V K,KUMAR K V,SHARMA S,et al.Comparison of methods of eye protection under general anaesthesia[J].Can J Anaesth,1998,45(6):575-577.
[16]谭云燕,宁传艺,刘丽清,等.全麻下头面部手术患者眼保护方法的对比研究[J].护理实践与研究,2012,9(3):15-16.
[17]叶素芳,林平联,钟玲.头颈部手术中两种眼部保护方法应用的效果评价[J].福建医药杂志,2012,34(6):151-152.
[18]张琳娟,黎黎,吴越,等.全麻下垂体瘤手术患者两种眼睛保护方法的效果观察[J].西部医学,2014,26(10):1323-1324.
[19]黄文娟.全麻俯卧位脊柱手术患者术中眼部保护方法的研究[J].齐齐哈尔医学院学报,2014,35(22):3382-3383.
[20]刘祖国,姚勇,孙秉基,等.过敏性结膜炎的临床特点[J].中国实用眼科杂志,2004,22(9):694-697.
[21]徐小群,曹茜,包纯纯,等.金霉素眼膏联合3M眼贴膜在头面部全麻手术患者中的应用[J]..现代中西医结合杂志,2008,17(14):2217-2218.