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护理干预预防危重症患者干眼的效果。

Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients.

机构信息

Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Am J Crit Care. 2019 Jul;28(4):299-306. doi: 10.4037/ajcc2019360.

Abstract

BACKGROUND

Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition.

OBJECTIVE

To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb).

METHODS

In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants' eyes using the fluorescein eye stain test and the Schirmer test for dry eye.

RESULTS

Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel ( = .04).

CONCLUSIONS

In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.

摘要

背景

危重症患者易发生干眼症。目前关于如何预防和治疗干眼症的研究较少。

目的

比较两种护理干预措施在预防成人重症监护病房患者干眼症中的效果:人工泪液(Lacribell;拉丁法玛)和人工泪液凝胶(Vidisic Gel;博士伦)。

方法

在这项随机对照试验中,140 名参与者被随机分配到 2 个治疗组中的 1 个:人工泪液组(n = 70)和人工泪液凝胶组(n = 70)。研究纳入标准如下:入住重症监护病房、年龄 18 岁或以上、入院时无干眼症诊断、接受机械通气、眨眼频率每分钟少于 5 次以及格拉斯哥昏迷量表评分为 7 分或更低。在连续 5 天内,一名对治疗分配不知情的研究人员使用荧光素眼染色试验和干眼病 Schirmer 试验评估参与者的眼睛。

结果

接受人工泪液的参与者中有 21%出现干眼症,而接受人工泪液凝胶的参与者中有 9%出现干眼症(=.04)。

结论

在这项研究中,人工泪液凝胶在预防干眼症方面优于人工泪液。这些结果可能有助于护士提供基于证据的眼部护理,以降低危重症患者干眼症的风险。

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