原发性开角型青光眼的护理-英语查房课件

ThenursingcareofPrimaryOpen-AngleGlaucoma原发性开角型青光眼的护理Contents主要内容Casepresentation病历介绍DefinitionofPOAGPOAG的定义Signsandsymptoms症状与体征Pathophysiology

病理生理Riskfactors危险因素Epidemiology流行病学Medicalandsurgicalmanagement药物和手术治疗Nursingaction护理措施Summary小结Casepresentation病历介绍MissKe,female,32y柯女士，32岁Chiefcomplaint:lefteyeblurredvisionformorethanhalfayear,withoutheadacheandvomitting主诉：左眼视力模糊半年多，无头痛和呕吐Familyhistory:grandmaandaunt家族史：外婆和小姨有青光眼pastmedicalhistory：lasertrebeculoplasty(2012-4-20)andTBX+MMC(2012-9-26)ofthelefteye病史：左眼分别于2014-4-20和2012-9-26进行了激光小梁成形术和TBX+mmcCasepresentation病历介绍Diagnosis:primaryopen-angleglaucoma(POAG)(OS)诊断：左眼原发性开角型青光眼

Casepresentation病历介绍

C/D（OS）:about0.6

左眼杯盘比：0.6

VF（OS）:Physiologicalblindspot

enlarged

左眼视野：生理性盲点扩大

Casepresentation病历介绍Surgeryundertaken:TBX+MMC（OS）手术：左眼TBX+MMCIOPaftersurgerydecreasedwithinnormalrange术后眼压降至正常水平DefinitionofPOAG

POAG的定义Primaryopen-angleglaucoma

iswhenopticnervedamageresultsinaprogressivelossofthevisualfield原发性开角型青光眼是指视神经损伤导致的进行性视野缺损AnormalrangeofvisualfieldThesameviewwithvisualfieldlossfromglaucomaSignsandsymptoms

症状与体征increasedC/Dratio(0.5-0.9)onfundoscopicexamination在眼底镜检查时杯盘比增大（0.5-0.9）Highmyopia高度近视Centralretinalveinocclusion

视网膜中央静脉阻塞Retinaldetachmentcausedbyaretinalhole

视网膜孔导致的网脱RiskfactorsforPOAG

POAG的危险因素Familyhistory家族史RaisedIOP高眼压Increasingage高龄African-Caribbeanorigin

加勒比黑人Thincorneas薄角膜Diabetesmellitus糖尿病Raisedsystolicbloodpresure高收缩压Eyedisease眼病Medicaltreatment

药物治疗βblockers(timolol)-twiceaday:reducingthesecretionofaqueousβ阻滞剂（timolol)）-每天2次：降低房水分泌Prostaglandinanalogues(latanoprost0.005%)-onceaday:increasinguveoscleraloutflowofaqueoushumor前列腺素衍生物（0.005%拉坦前列素）-每天1次：增加房水经葡萄膜巩膜通道流出Medicaltreatment

药物治疗Parasympathomimeticagents(pilocarpine1-4%)-threetimesaday:increasingoutflowoftheaqueoushumour拟复交感神经药（1-4%毛果芸香碱）–每天3次，增加放水的流出Carbonicanhydraseinhibitors(brinzolamide)–threetimesaday:loweringsecretionofaqueoushumorbyinhibitingcarbonicanhydraseintheciliarybody碳酸酐酶抑制剂（布林佐胺）-每天3次：通过抑制睫状肌上碳酸酐酶受体，降低房水分泌Surgicaltreatment

手术治疗Argonordiodelasertrabeculoplasty-forelderlypatient亚激光或双极激光小梁成形术-用于老年患者Trabeculectomy-goldstandardglaucomafiltrationprocedure小梁切除术-青光眼滤过手术金标准Glaucomavalveimplantation青光眼引流阀植入术TrabeculectomyGlaucomavalvePossiblesurgicalcomplication

可能的手术并发症postoperativescarringofthedrainagechannelanddrainagebleb术后引流通道或滤过泡瘢痕形成

antiscarringagents抗瘢痕药物postoperativecataractandhypotony

术后白内障和低眼压ReductioninpostoperativeBCVA

术后矫正视力降低Infection

感染Nursingaction

护理措施Providethepatientwithinformationonhistreatment

向患者提供关于治疗的信息Emphasistheimportanceofinstillingeyedropsfollowingthedoctor’sorderinordertocontroltheIOPandpreventingfurthervisualfieldloss

强调遵医嘱滴眼药水的重要性，从而控制眼压，防止视野进一步缺损Observethesideeffectofmedication

观察药物的不良反应Donotusediazepamtabletsforglaucomapatients

青光眼患者不能使用地西泮Dietaryeducationisthesameasangle-closureglaucoma

饮食宣教与急闭相同Nursingaction

护理措施Instillationofdrops滴眼药水1.antibiotic

1.抗生素2.