青光眼的护理资料课件.ppt
TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential护理查房 青光眼的护理 榆林市第四医院榆林市第四医院 五官科 赵瑜TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2013年3月10日16日被定为第六个世界青光眼周，今年的活动主题是“The world is a wonder to see every day,so dont let glaucoma get in the way”，翻译成中文就是“世界天天都精彩，别让青光眼成为世界天天都精彩，别让青光眼成为阻挡您欣赏世界的无赖阻挡您欣赏世界的无赖!”。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential概念：视神经凹陷性萎缩 视野缺损 病理性眼压增高TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential眼压？正常眼压：？1021mmHg 正常眼压性青光眼 高眼压症双眼压差不5mmHg 24小时眼压波动不8mmHgTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential眼压的稳定性：房水生成 与排出房水：睫状突 后房 瞳孔 前房 小梁网通道 葡萄膜巩膜通道TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential青光眼的分类：原发性青光眼 闭角型青光眼 急性 慢性 开角型青光眼 继发性青光眼 先天性青光眼TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential急性期表现：眼红，眼疼，视力下降。结膜混合性充血，角膜上皮水肿，前房极浅，瞳孔中等散大，光反应消失。眼压通常50mmHgTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential紧急处理原则：局部点用缩瞳剂：1%毛果芸香碱，频点。联合：全身应用高渗剂，如20%甘露醇 碳酸酐酶抑制剂 局部点用-受体阻滞剂全身症状严重者：止吐，镇静，抗炎缓解后进一步手术治疗。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential治疗方法激光治疗手术治疗药物治疗TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential术前检查常规检查：1、全身检查：血压、血糖、心肺肝肾功能、凝血常规、血型，二便，避开经期、孕期。2、眼部检查：视力、视野、眼压、眼底、前房、角镜检查。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential青光眼治疗护理的新进展 激光治疗青光眼是近年青光眼治疗的一大进步，激光虹膜打孔代替了虹膜周切术，激光虹膜打孔代替了虹膜周切术，激光小梁成形术为 开角性青光眼的治疗提供了一种手段，开角性青光眼的治疗提供了一种手段，使大量病人避 免了手术治疗。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential患 者 基 本 资 料 床号：19姓名性别：女 年龄：73岁 民族：汉 文化程度:小学 无 家族史：无类似病史、无遗家族史：无类似病史、无遗传病史。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential现 病 史 患者诉6天前无明显诱因出现右眼胀痛，患者诉6天前无明显诱因出现右眼胀痛，视下 伴右侧头痛，无恶心呕吐，降，伴右侧头痛，无恶心呕吐，就诊时右眼眼 压为40mmHg,诊断为青光眼于2012 02-03入院 40mmHg,诊断为青光眼于2012入院，压为40mmHg,诊断为青光眼于2012-02-03入院，患者精神食欲可，大小便正常，生活自理。患者精神食欲可，大小便正常，生活自理。给 20%甘露醇等降眼压药物治疗后眼压控制在 予20%甘露醇等降眼压药物治疗后眼压控制在 18-24mmHg之间 02-06在局麻下行右眼小梁切 之间，18-24mmHg之间，02-06在局麻下行右眼小梁切 除术，术后眼压一直在正常范围，除术，术后眼压一直在正常范围，眼部也无胀 球结膜对合好，02-13顺利出院 顺利出院。痛，球结膜对合好，于02-13顺利出院。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential123 护理要点TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential术前护诊断知识缺乏-与患者不了解疾病治疗和护理有关焦虑-与环境改变有关疼痛-与眼压高有关TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2023/1/6心理和生理舒适感得到提高通过护理措施，使患者改变行为，适应疾病生活采取止痛措施后，能说出疼痛减轻的表现护理目标TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential护理措施保持病房安静,遵医嘱给降压止痛药教会患者疼痛时分散注意力的方法向患者解释疼痛的原因，取得配合TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2023/1/61、2天后患者诉疼痛减轻4、使病人能尽快适应自己的角色2、5天后自天后自诉焦虑减轻诉焦虑减轻3、患者了解青光眼的基础知识效果效果评价评价5、讲解疾病的知识，使病人放松心情TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential术后护理诊断1、出血 2、感染 3、疼痛 4、体液不足的危险 TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential术后病人恢复好，无出血术后病人生命体征正常，无感染病人能说出疼痛的部位及程度病人进食情况好，能保证足够的营养摄入护理目标护理目标TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2023/1/6正确为病人滴注眼药水，防止感染。指导患者避免长时间低头、弯腰、咳嗽，打喷嚏。嘱勿食酸辣刺激性食物，食蔬菜水果，保持大便通畅。每次饮水量不超过300ML。不要长时间呆在黑暗中，防眼压增高。观察生命体征，耐心听取病人主诉。护理措施TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2023/1/6效果评价3、患者能保证每天足够的营养摄入。2、术后患者未诉疼痛。1、患者术后恢复好，未有出血，无感染，顺利出院。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential2023/1/6出院指导遵医嘱按时用药，严格查对眼药。合理安排生活，保持乐观情绪、不喝浓茶，不暴饮暴食，多食粗纤维食物，保持大便通畅。不宜长时间低头，弯腰，不在光线过暗处久留。预防感冒，防止伤口感染，定期复查。TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential患者资料TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential谢谢 谢谢TOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidentialTOPCON CORPORATION All rights reserved.ConfidentialConfidentialConfidentialConfidential护理业务学习记录护理业务学习记录术后病人生命体征正常，无感染病人能说出疼痛的部位及程度病人进食情况好，能保证足够的营养摄入目录目录
