Key words retinal detachment; postoperative complications; Care
Vitrectomy combined with intraocular silicone oil tamponade for complicated retinal detachment is a commonly used surgical techniques, intraocular silicone oil can improve retinal reattachment rate, improve the visual prognosis, they often bring many complications, which is a high intraocular pressure common complication [1]. Therefore, to do after high intraocular pressure in the observation and nursing care is particularly important, now I understand the report is as follows Nursing.
1 Clinical data
January 2008 ~ January 2009 retinal detachment surgery patients were treated a total of 46 cases, including 10 patients with ocular hypertension, 8 males and 2 females, aged 18 to 76 years, six cases of the right eye left eye four cases .
2 The causes of
High intraocular pressure after surgery are common reasons for improper posture, surgical stimulation reaction of ciliary body edema and uveitis, intravitreal gas injection or silicone oil injection, excessive intraocular silicone oil tamponade, silicone oil block aphakia pupil.
3 nursing
3.1 Psychological care in nursing work, in addition to reducing postoperative pain and help maintain correct posture and improve comfort givers, but also enhance communication with patients. More attention to comfort patient, to prevent the mood swings lead to increased intraocular pressure and related diseases and more knowledge to explain to patients, teaching patients with some mental relaxation techniques such as deep breathing, listening to music, to psychology and mental relaxation, and actively cooperate with the treatment to reduce complications.
3.2 light digestible food rich in vitamin daily to give more food, Wu Shi strong irritant spicy food such as tea, coffee, onions, garlic, etc., to avoid flatulence foods such as milk, soy products, etc., so as not to increase abdominal pressure to maintain smooth stool the intraocular pressure increased again, the general amount of drinking water for a period not exceeding 300ml, to ensure adequate sleep.
3.3 adopt the correct posture position after care is very important to help reduce postoperative complications after vitrectomy combined with silicone oil filling hole in the highest position in order to make the top of the bubble or silicone oil pressure hole, promote healing [2]. Orders to prone position. As a long time can cause stomach eyelid and facial edema, dizziness, neck and shoulder, back muscle fatigue, pain, loss of appetite and even flustered, chest tightness and discomfort, thus affecting the results of operations, in order to reduce patient adverse events in the supine period and improve the comfort. Adhering to the hole in the highest, based on the principle of the conventional take the first low-sitting, lying, walking three alternate positions, such as night sleep, and take down lateral position eye health, eye surgery to avoid pressure and maintain airway ; during the day and the prone position, place the cushion in the chest and abdomen, forehead and the soft pad under the Ministry of stool care, may also be sitting in a chair, edge of the bed put a soft pillow head on the soft pillow; meals to take a prone position bit, to keep down meal, where appropriate, from the slow motion activities of the body, massage body, promote blood circulation, relieve nerve compression symptoms, and increased patient comfort [2].
3.4 The disposal of high intraocular pressure gas injection, or intravitreal silicone oil to push the retina into the filling, separate to start the formation of retinal folds have closed hole to reach the goal. At this point elevation of intraocular pressure occurred in the gas injection after 12 to 96 hours can be intense pain, and gradually increased. Therefore, close monitoring of intraocular pressure after surgery while observing eye surgery without pain, if given timely reporting of rapid intravenous infusion of a doctor and was prescribed 20% mannitol, oral acetazolamide, topical 0.5% timolol eye drops However, excessive intraocular silicone oil tamponade antihypertensive drugs in patients with poor results, the need some gas or silicone oil removal to the intraocular pressure returned to normal.
3.5 is due to surgical nursing symptomatic or stimulate creativity, especially condensation, coagulation induced elevation of intraocular pressure patients often experience headaches, eye pain increased, this time should be given adequate psychological support, elimination of tension, emotion while giving oral indomethacin dexamethasone injection to ease the subconjunctival injection line antihypertensive treatment when necessary.
3.6 Note that the water cycle in this room more than the occurrence time of the IOP 2 to 4 days after surgery, should observe the 6 o'clock position holes are smooth cut iris weeks, the occurrence of adhesion will affect the housing cycle delay should be promptly picked anterior chamber puncture Cut holes open week, recovery room circulation, patients continue to take the prone position to rest, adhere to the eye, intraocular pressure, self-healing.
4 discharge guidance
Note eye health, adhere to the drops with eye drops to prevent infection; eye surgery to avoid a collision, within six months after surgery to avoid heavy manual labor and strenuous exercise, be careful not to overuse, to prevent further reduction of retinal detachment; periodic review after discharge from hospital 1 week outpatient review. Shadow appears before your eyes, double vision, flashing a sense of decreased visual acuity, visual distortion, indicating that the retina has not fully reset or there is a new hole, should stay in bed and immediately go to hospital. To the hospital after 1 month of retinal situation; 3 months after silicone oil to take back to the hospital on time.
Vitrectomy combined with intraocular silicone oil tamponade for complicated retinal detachment is a commonly used surgical techniques, intraocular silicone oil can improve retinal reattachment rate, improve the visual prognosis, they often bring many complications, which is a high intraocular pressure common complication [1]. Therefore, to do after high intraocular pressure in the observation and nursing care is particularly important, now I understand the report is as follows Nursing.
1 Clinical data
January 2008 ~ January 2009 retinal detachment surgery patients were treated a total of 46 cases, including 10 patients with ocular hypertension, 8 males and 2 females, aged 18 to 76 years, six cases of the right eye left eye four cases .
2 The causes of
High intraocular pressure after surgery are common reasons for improper posture, surgical stimulation reaction of ciliary body edema and uveitis, intravitreal gas injection or silicone oil injection, excessive intraocular silicone oil tamponade, silicone oil block aphakia pupil.
3 nursing
3.1 Psychological care in nursing work, in addition to reducing postoperative pain and help maintain correct posture and improve comfort givers, but also enhance communication with patients. More attention to comfort patient, to prevent the mood swings lead to increased intraocular pressure and related diseases and more knowledge to explain to patients, teaching patients with some mental relaxation techniques such as deep breathing, listening to music, to psychology and mental relaxation, and actively cooperate with the treatment to reduce complications.
3.2 light digestible food rich in vitamin daily to give more food, Wu Shi strong irritant spicy food such as tea, coffee, onions, garlic, etc., to avoid flatulence foods such as milk, soy products, etc., so as not to increase abdominal pressure to maintain smooth stool the intraocular pressure increased again, the general amount of drinking water for a period not exceeding 300ml, to ensure adequate sleep.
3.3 adopt the correct posture position after care is very important to help reduce postoperative complications after vitrectomy combined with silicone oil filling hole in the highest position in order to make the top of the bubble or silicone oil pressure hole, promote healing [2]. Orders to prone position. As a long time can cause stomach eyelid and facial edema, dizziness, neck and shoulder, back muscle fatigue, pain, loss of appetite and even flustered, chest tightness and discomfort, thus affecting the results of operations, in order to reduce patient adverse events in the supine period and improve the comfort. Adhering to the hole in the highest, based on the principle of the conventional take the first low-sitting, lying, walking three alternate positions, such as night sleep, and take down lateral position eye health, eye surgery to avoid pressure and maintain airway ; during the day and the prone position, place the cushion in the chest and abdomen, forehead and the soft pad under the Ministry of stool care, may also be sitting in a chair, edge of the bed put a soft pillow head on the soft pillow; meals to take a prone position bit, to keep down meal, where appropriate, from the slow motion activities of the body, massage body, promote blood circulation, relieve nerve compression symptoms, and increased patient comfort [2].
3.4 The disposal of high intraocular pressure gas injection, or intravitreal silicone oil to push the retina into the filling, separate to start the formation of retinal folds have closed hole to reach the goal. At this point elevation of intraocular pressure occurred in the gas injection after 12 to 96 hours can be intense pain, and gradually increased. Therefore, close monitoring of intraocular pressure after surgery while observing eye surgery without pain, if given timely reporting of rapid intravenous infusion of a doctor and was prescribed 20% mannitol, oral acetazolamide, topical 0.5% timolol eye drops However, excessive intraocular silicone oil tamponade antihypertensive drugs in patients with poor results, the need some gas or silicone oil removal to the intraocular pressure returned to normal.
3.5 is due to surgical nursing symptomatic or stimulate creativity, especially condensation, coagulation induced elevation of intraocular pressure patients often experience headaches, eye pain increased, this time should be given adequate psychological support, elimination of tension, emotion while giving oral indomethacin dexamethasone injection to ease the subconjunctival injection line antihypertensive treatment when necessary.
3.6 Note that the water cycle in this room more than the occurrence time of the IOP 2 to 4 days after surgery, should observe the 6 o'clock position holes are smooth cut iris weeks, the occurrence of adhesion will affect the housing cycle delay should be promptly picked anterior chamber puncture Cut holes open week, recovery room circulation, patients continue to take the prone position to rest, adhere to the eye, intraocular pressure, self-healing.
4 discharge guidance
Note eye health, adhere to the drops with eye drops to prevent infection; eye surgery to avoid a collision, within six months after surgery to avoid heavy manual labor and strenuous exercise, be careful not to overuse, to prevent further reduction of retinal detachment; periodic review after discharge from hospital 1 week outpatient review. Shadow appears before your eyes, double vision, flashing a sense of decreased visual acuity, visual distortion, indicating that the retina has not fully reset or there is a new hole, should stay in bed and immediately go to hospital. To the hospital after 1 month of retinal situation; 3 months after silicone oil to take back to the hospital on time.