CAJ | 학술논문

目的：探讨Ex-PRESS青光眼引流器植入术治疗外伤性青光眼的术后观察与护理要点。方法回顾性分析19例（19只眼）外伤性青光眼患者的临床资料，所有患者均实施巩膜瓣下Ex-PRESS青光眼引流器植入术。术后观察患者视力、前房深度、前房积血、眼压及滤过泡情况，实施并总结规范的术后护理。结果术后3个月矫正视力提高2～3行者9只眼（47．4％），矫正视力不变者（含视力增加或减少1行）9只眼（47．4％），矫正视力下降2～3行者1只眼（5．3％）。术后第1天发生浅前房者2只眼（10．5％），给予复方托吡卡胺滴眼液散瞳1～4次，第2天前房均恢复正常深度。术后第1周内有19眼眼压值5～16 mmHg。3个月时有1只眼呈包囊型滤过泡眼压偏高，眼压36 mmHg；维持在9～17 mmHg者18只眼。术后3个月滤过泡情况：Ⅰ型者3只眼，Ⅱ型者15只眼，Ⅳ型者1只眼，Ⅰ型和Ⅱ型者共18只眼，占94．7％，为功能性滤过泡。结论 Ex-PRESS青光眼引流器植入治疗外伤性青光眼术后视力改善、目标眼压稳定。规范的术后护理有助于减少术后并发症、提高患者的手术治疗效果。
목적：탐토Ex-PRESS청광안인류기식입술치료외상성청광안적술후관찰여호리요점。방법회고성분석19례（19지안）외상성청광안환자적림상자료，소유환자균실시공막판하Ex-PRESS청광안인류기식입술。술후관찰환자시력、전방심도、전방적혈、안압급려과포정황，실시병총결규범적술후호리。결과술후3개월교정시력제고2～3행자9지안（47．4％），교정시력불변자（함시력증가혹감소1행）9지안（47．4％），교정시력하강2～3행자1지안（5．3％）。술후제1천발생천전방자2지안（10．5％），급여복방탁필잡알적안액산동1～4차，제2천전방균회복정상심도。술후제1주내유19안안압치5～16 mmHg。3개월시유1지안정포낭형려과포안압편고，안압36 mmHg；유지재9～17 mmHg자18지안。술후3개월려과포정황：Ⅰ형자3지안，Ⅱ형자15지안，Ⅳ형자1지안，Ⅰ형화Ⅱ형자공18지안，점94．7％，위공능성려과포。결론 Ex-PRESS청광안인류기식입치료외상성청광안술후시력개선、목표안압은정。규범적술후호리유조우감소술후병발증、제고환자적수술치료효과。
Objective To explore the postoperative observation and nursing points of traumatic glaucoma patients with Ex-PRESS glaucoma filtration device implantation .Methods The clinical data of 19 patients ( 19 eyes ) with traumatic glaucoma were retrospectively analyzed , and all patients received the Ex-PRESS glaucoma filtration device implantation under the scleral flap .The visual acuity , anterior chamber depth and hyphema , intraocular pressure and filtering bleb after the operation were observed , and the standardized postoperative nursing was carried out and summarized .Results The cases of visual acuity with the increase of 2 to 3 lines, the unchanged including the increase or decrease of 1 line and the decrease of 2 to 3 lines were respectively 9 (47.4%), 9 (47.4%) and 1 (5.3%) case 3 months after the operation.The cases of shallow anterior chamber were 2 cases (10.5%) one day after the operation, and the anterior chamber depth returned to normal on the second day after the operation through one to four mydriasis .The cases of intraocular pressure with 5 to 16 mmHg were 19 cases on the first week after the operation .The cases of intraocular pressure with 36 mmHg accompanied by filtering bleb were one case , and the cases of intraocular pressure with 9 to 17 mmHg were 18 cases 3 months after the operation .The cases of filtering bleb includingⅠ,Ⅱand Ⅳ were respectively 3, 15, 1 case 3 months after the operation, and the cases of functional filtering bleb includingⅠandⅡwere 18 cases (94.7%).Conclusions Ex-PRESS glaucoma filtration device implantation can improve the postoperative vision , and control the postoperative intraocular pressure in patients with traumatic glaucoma .The standardized postoperative nursing can reduce the postoperative complication , and increase the surgical effects .