局麻下糖尿病视网膜脱离术患者的动态监测及护理干预

目的探讨对糖尿病视网膜脱离（POR）患者在局麻下,行玻璃体切割术联合视网膜光凝、重水硅油填充、玻璃体注气、晶体超声乳化的术中配合。主动协助进行动态监测。方法对63例66只眼糖尿病视网膜脱离患者术前用药,玻璃体切割术联合视网膜光凝、重水硅油填充、玻璃体注气、晶体超声乳化的术中配合。术中监控血糖：术中每小时测血糖1次,一般使血糖维持在4.4～8.3 mmol/L,注意低血糖表现。必要时口服或静脉给糖。术中心电监护：术中对高血压、眼压高的患者每15min测血压心率1次,吸氧、氧饱和度100%。应用胰岛素时注意避免发生低血糖。结果配合医生顺利完成术中护理监测。结论通过心理安慰,准确给药,严格规范手术的配合和动态监测,能保证手术的顺利完成。

Dynamic monitoring of patients with diabetic retinal detachment under local anesthesia its nursing intervention

Objective To investigate the dynamic monitoring and cooperation in the surgery of diabetic retinal detachment patients under local anesthesia who underwent vitrectomy combined with retinal photocoagulation,heavy silicone oil filling,gas injection,crystal ultrasonic emulsification.Methods Preoperative medication was administered to 63 patients（66 eyes） with diabetic retinal detachment before they underwent vitrectomy combined with retinal photocoagulation,heavy silicone oil filling,gas injection and crystal ultrasonic emulsification.Intraoperative monitoring of blood glucose was conducted.Blood glucose was measured once per hour.Generally blood glucose kept at a level of 4.4-8.3 mmol/L.Attention was paid to hypoglycemia.When necessary,oral or intravenous glucose was administered.An intraoperative ECG monitoring was implemented.The heart rates of patients with high blood pressure and intraocular pressure were measured every fifteen minutes.Oxygen and oxygen saturation reached 100%.Insulin was applied with caution to avoid hypoglycemia.Results Doctors successfully completed intraoperative monitoring during operation.Conclusion Good psychological comfort,precise medication,strict and programmed cooperation and dynamic monitoring are essential to a successful operation.