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成人患者斜视手术期望与实际手术体验的差异。

Differences between patient expectations and actual strabismus surgery experience in adults.

作者信息

Ryu Won Yeol, Sohn Eun Jung, Ahn Hee Bae

机构信息

Department of Ophthalmology, Dong-A University College of Medicine, Busan, Republic of Korea.

Department of Ophthalmology, Dong-A University College of Medicine, Busan, Republic of Korea.

出版信息

Can J Ophthalmol. 2015 Feb;50(1):61-7. doi: 10.1016/j.jcjo.2014.09.009.

DOI:10.1016/j.jcjo.2014.09.009
PMID:25677285
Abstract

OBJECTIVE

To provide objective information on patient discomfort after strabismus surgery.

DESIGN

Prospective cohort study.

PARTICIPANTS

Forty-nine consecutive adult patients undergoing strabismus surgery.

METHODS

A questionnaire was used to evaluate the following on a scale of 0 (absent) to 10 (very severe): patients' expectations of pain, blurred vision, daily life disruption, diplopia, conjunctival redness, foreign body sensation, eyelid swelling, postoperative nausea and vomiting (PONV), and preoperative cosmetic satisfaction. Patients answered the questionnaire at 6 hours, 1 day, 2 days, 3 days, 1 week, 2 weeks, 1 month, and 3 months after surgery, focusing on the actual experience. Patient was also investigated according to previous surgical history and the surgery type.

RESULTS

In the 42 patients included in the analyses, postoperative pain (p = 0.049) and PONV (p = 0.039) occurred at significantly lower-than-anticipated levels. Blurred vision (p = 0.019), daily life disruption (p = 0.009), and conjunctival redness (p < 0.001) occurred at significantly higher-than-expected levels, and patients felt that conjunctival redness was the most severe symptom occurring immediately after surgery. Patients who required vertical or oblique muscle procedures (p = 0.046) or had undergone previous ophthalmic surgery (p = 0.025) experienced higher levels of postoperative pain than they had preoperatively anticipated.

CONCLUSIONS

Preoperative anticipations were quite different from actual postoperative experiences in adults undergoing strabismus surgery. Our results will allow surgeons to objectively educate patients before the operation about the postoperative course and to explain the inconveniences and minor side effects expected during the recovery process.

摘要

目的

提供斜视手术后患者不适情况的客观信息。

设计

前瞻性队列研究。

参与者

49例连续接受斜视手术的成年患者。

方法

使用问卷以0(无)至10(非常严重)的量表评估以下内容:患者对疼痛、视力模糊、日常生活干扰、复视、结膜充血、异物感、眼睑肿胀、术后恶心和呕吐(PONV)以及术前美容满意度的预期。患者在术后6小时、1天、2天、3天、1周、2周、1个月和3个月回答问卷,重点关注实际体验。还根据既往手术史和手术类型对患者进行调查。

结果

纳入分析的42例患者中,术后疼痛(p = 0.049)和PONV(p = 0.039)的发生水平明显低于预期。视力模糊(p = 0.019)、日常生活干扰(p = 0.009)和结膜充血(p < 0.001)的发生水平明显高于预期,且患者认为结膜充血是术后立即出现的最严重症状。需要进行垂直或斜肌手术的患者(p = 0.046)或既往接受过眼科手术的患者(p = 0.025)术后疼痛水平高于术前预期。

结论

斜视手术成年患者术前预期与术后实际体验差异较大。我们的结果将使外科医生能够在手术前客观地告知患者术后过程,并解释恢复过程中预期的不便和轻微副作用。

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