论文部分内容阅读
[摘要] 目的 探讨鼻内镜下经泪阜径路联合Medpor植入整复单纯性眶内侧壁骨折患者的围手术期护理干预效果。方法 选取2011年6月～2014年5月在我院接受鼻内镜下经泪阜径路行眶内侧壁骨折整复的单纯性眶内侧壁骨折患者51例，按照护理方法的不同分为干预组26例，对照组25例。对照组患者采用常规护理；干预组患者在对照组基础上增加围手术期的综合性护理干预，比较两组护理前后焦虑、抑郁评分、生活质量得分、生活质量维度得分及复视治愈率情况。 结果 干预组焦虑、抑郁评分均与对照组比较，明显降低（P<0.01）；干预组干预后的生活质量、生活质量维度中的身体功能、社会活动、精神心理得分均明显高于对照组（P<0.01），随访6个月，干预组复视治愈率为96.15%，高于对照组的84.00%。 结论 对鼻内镜下经泪阜径路行眶内侧壁骨折整复术的围手术期实施综合性的护理干预措施可以改善患者的焦虑、恐惧情绪，减少手术并发症，减轻患者痛苦，提高患者的生活质量。
[关键词] 鼻内镜；泪阜径路；眶内侧壁骨折；护理
[中图分类号] R473.77；R765.9 [文献标识码] B [文章编号] 1673-9701（2015）29-0128-04
Perioperative nursing of patients with isolated medial orbital fracture reconstructed by endoscopic transcaruncular approach
XU Shaojun CHEN Guohai
Department of Ophthalmic， Quzhou People’s Hospital in Zhejiang Province， Quzhou 324000， China
[Abstract] Objective To study the perioperative nursing of patients with isolated medial orbital fracturereconstructed by endoscopic transcaruncular approach with Medpor surgical implant. Methods This prospective interventional case series included 51 consecutive patients receiving endoscopic transcaruncular approach to reconstruct isolated medial orbital fracture in our hospital from June 2011 to May 2014. They were divided into two groups according to the different nursing methods. There were 25 cases in the control group who received routine nursing. While 26 cases in the interventional group received perioperative comprehensive nursing besides the conventional way. The scores of anxiety， depression， patients’ life quality， physical function， social activities， mental psychology and the cure rate of diplopia were recorded. Results The scores of anxiety and depression in the interventional group were significantly lower than the control group（P<0.01）. Meanwhile， the scores of patients’ life quality， physical function， social activities， mental psychology in the interventional group were significantly higher than the control group（P<0.01）. The follow-up lasted for six months， the cure rate of diplopia in the intervention group was higher than the control group（96.15% vs 84.00%）. Conclusion Perioperative nursing of patients with isolated medial orbital fracture reconstructed by endoscopic transcaruncular approach can relieve anxiety and fear， ease pain， and reduce the operation complications， thus effectively improving the quality of life.
[Key words] Endoscopy； Transcaruncular approach； Medial orbital fracture；Nursing
眼眶爆裂性骨折是指外力作用于眼眶导致眶内压突然增高，眶壁薄弱处发生骨折及移位，其中又以单纯性眶内侧壁骨折多发，可高达41.5%[1]。内窥镜下经泪阜径路行眶内侧壁骨折整复术可改变传统术式采用面部皮肤切口、术野暴露受限、难以有效去除骨折碎片及修复骨折致使术后遗留面部瘢痕影响容貌的缺点，获得更为安全有效的疗效[2，3]。2011年6月～2014年5月，本院眼科中心对51例单纯性眶内侧壁骨折患者行鼻内镜下经泪阜径路眼眶整复联合Medpor植入术，同时对其中26例患者配合有效合理的圍手术综合性护理干预措施，取得了良好的临床疗效，现将结果报道如下。
[关键词] 鼻内镜；泪阜径路；眶内侧壁骨折；护理
[中图分类号] R473.77；R765.9 [文献标识码] B [文章编号] 1673-9701（2015）29-0128-04
Perioperative nursing of patients with isolated medial orbital fracture reconstructed by endoscopic transcaruncular approach
XU Shaojun CHEN Guohai
Department of Ophthalmic， Quzhou People’s Hospital in Zhejiang Province， Quzhou 324000， China
[Abstract] Objective To study the perioperative nursing of patients with isolated medial orbital fracturereconstructed by endoscopic transcaruncular approach with Medpor surgical implant. Methods This prospective interventional case series included 51 consecutive patients receiving endoscopic transcaruncular approach to reconstruct isolated medial orbital fracture in our hospital from June 2011 to May 2014. They were divided into two groups according to the different nursing methods. There were 25 cases in the control group who received routine nursing. While 26 cases in the interventional group received perioperative comprehensive nursing besides the conventional way. The scores of anxiety， depression， patients’ life quality， physical function， social activities， mental psychology and the cure rate of diplopia were recorded. Results The scores of anxiety and depression in the interventional group were significantly lower than the control group（P<0.01）. Meanwhile， the scores of patients’ life quality， physical function， social activities， mental psychology in the interventional group were significantly higher than the control group（P<0.01）. The follow-up lasted for six months， the cure rate of diplopia in the intervention group was higher than the control group（96.15% vs 84.00%）. Conclusion Perioperative nursing of patients with isolated medial orbital fracture reconstructed by endoscopic transcaruncular approach can relieve anxiety and fear， ease pain， and reduce the operation complications， thus effectively improving the quality of life.
[Key words] Endoscopy； Transcaruncular approach； Medial orbital fracture；Nursing
眼眶爆裂性骨折是指外力作用于眼眶导致眶内压突然增高，眶壁薄弱处发生骨折及移位，其中又以单纯性眶内侧壁骨折多发，可高达41.5%[1]。内窥镜下经泪阜径路行眶内侧壁骨折整复术可改变传统术式采用面部皮肤切口、术野暴露受限、难以有效去除骨折碎片及修复骨折致使术后遗留面部瘢痕影响容貌的缺点，获得更为安全有效的疗效[2，3]。2011年6月～2014年5月，本院眼科中心对51例单纯性眶内侧壁骨折患者行鼻内镜下经泪阜径路眼眶整复联合Medpor植入术，同时对其中26例患者配合有效合理的圍手术综合性护理干预措施，取得了良好的临床疗效，现将结果报道如下。