目的：探讨视网膜脱离术后特殊体位诱发肩颈腰椎不适的干预措施。方法：选取我院2017年1月~2019年12月行玻璃体切除术联合硅油填充术的120例视网膜脱离患者为研究对象，依据随机数字表法分为两组，60例每组，对照组实施常规护理，观察组实施循证护理，比较两组患者的最佳矫正视力、特殊体位依从性、舒适度评分、肩颈腰椎不适发生率、不良情绪评分、睡眠质量评分、生活质量评分及护理满意度。结果：两组护理后的最佳矫正视力均较护理前增高(P < 0.05)，而护理后的最佳矫正视力在组间比较无明显差异(P > 0.05)。观察组的特殊体位总依从率95.00%高于对照组80.00% (P < 0.05)。肩颈腰椎不适发生率观察组1.67%低于对照组11.67% (P < 0.05)。护理后，观察组的舒适度、生活质量评分均高于对照组，观察组的焦虑、抑郁、睡眠质量评分均低于对照组，P均<0.05。护理满意率观察组96.67%高于对照组81.67% (P < 0.05)，差异有统计学意义。结论：在视网膜脱离手术后实施循证护理，可有效提高患者对术后特殊体位的依从性，有利于提高舒适度，减少肩颈腰椎不适发生，进一步改善患者心理状态，提升其睡眠质量、生活质量和满意度，促进患者早期康复，值得借鉴应用。
Objective: To explore the
intervention measures of shoulder neck lumbar discomfort induced by special
posture after retinal detachment surgery. Methods: From January 2017 to
December 2019, 120 cases of patients with retinal detachment who underwent
vitrectomy combined with silicone oil
tamponade in our hospital were selected as the research object. According to
the random number table method, they
were divided into two groups, 60 cases in each group. The control group received
routine nursing, while the observation group received evidence-based nursing.
The best corrected vision, compliance of
special body position, comfort score, incidence rate of discomfort of shoulder,
neck and lumbar spine, adverse emotion score, sleep quality score, quality of
life score and nursing satisfaction degree of the two groups were compared.
Results: The best corrected vision of the two groups after nursing was higher
than that before nursing (P < 0.05), but there was no significant difference between the two groups after nursing (P > 0.05). The total compliance rate
of special posture in the observation group was 95.00% higher than 80.00% in
the control group (P < 0.05). The incidence of shoulder, neck and lumbar discomfort in the observation group was 1.67% lower than that in the control group (11.67%) (P < 0.05). After nursing, compared with the control group, the comfort and quality of life scores of the observation group were higher, and the anxiety, depression and sleep quality scores of the observation group were lower, all P < 0.05. The total satisfaction rate of nursing care in the observation group was 96.67% higher than that in the control group 81.67% (P < 0.05). Conclusion: The implementation of evidence-based nursing after retinal detachment surgery can effectively improve the compliance of patients with special post-operation postures, help to improve comfort, reduce discomfort
References
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Matlach, J., Pflueger, B., Hain, J., et al. (2015) Inner and Outer Central Retinal Findings after Surgery for Rhegmatog-enous Retinal Detachment Using Different Spectral-Domain Optical Coherence Tomography Devices. Graefe’s Archive for Clinical and Experimental Ophthalmology, 253, 369-380. https://doi.org/10.1007/s00417-014-2713-4
Salah, K.R., Morillo-Sanchez, J., et al. (2015) The Effect of Peripapillary Detachment on Retinal Nerve Fiber Layer Measure-ment by Spectral Domain Optical Coherence Tomography in High Myopia. Ophthalmologica, 233, 209-215.
https://doi.org/10.1159/000371903
dell’Omo, R., Viggiano, D., Giorgio, D., et al. (2015) Restoration of Foveal Thickness and Architecture after Macula-Off Retinal Detachment Repair. Investigative Ophthalmology & Visual Science, 56, 1040-1050.
https://doi.org/10.1167/iovs.14-15633
