基于证据的重症监护病房患者眼部护理方案的实施对眼部表面疾病的影响。

The effect of implementation of evidence-based eye care protocol for patients in the intensive care units on superficial eye disorders.

机构信息

Critical Care Nursing, International Campus of Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Health in Disasters and Emergencies, Shahid Rahnemoun Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

BMC Ophthalmol. 2021 Jul 13;21(1):275. doi: 10.1186/s12886-021-02034-x.

DOI:10.1186/s12886-021-02034-x

PMID:34256729

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8276465/

Abstract

BACKGROUND

Superficial eye disorders are one of the most common complications of improper eye care in intensive care units that can lead to corneal ulcers and permanent eye damage. The aim of this study was to determine the effect of the implementation of eye care protocol on the incidence of infection and superficial eye disorders in patients admitted to intensive care units.

METHODS

This study was a cross-over clinical trial that was performed on 32 patients admitted to the intensive care unit with reduced or no blink reflex following loss of consciousness or receiving sedatives. The eye of the test group received eye care according to the protocol and the eye of the control group received the routine care of the ward. The data collection form included demographic and clinical information and the clinical score scale of superficial eye disorders, which were completed in 7 days for both eyes. Data analysis was performed by McNemar and Cochran tests with a 95 % confidence interval.

RESULTS

In the study of superficial eye disorders, the frequency of dacryorrhea and hyperemia was not significantly different in the second to seventh days in the control and test eyes (P < 0.05). The frequency of xerophthalmia was not significantly different between the control and the test eyes on the second to third days (P < 0.05), but there was a significant difference on the fourth, fifth, sixth, and seventh days (P = 0.0001). Also, the frequency of corneal opacity was not significantly different in the second and third days (P < 0.05), but in the fourth (P < 0.05), fifth, sixth, and seventh days, this difference was significant (P = 0.0001).

CONCLUSIONS

Based on the results, although the implementation of eye care protocol has been able to have a significant effect on reducing ocular complications and problems, routine eye care in the intensive care unit also has clinical effectiveness. Therefore, in order to prevent and completely eliminate eye disorders in the intensive care unit, more evidence and research are needed.

TRIAL REGISTRATION

The trial was retrospectively registered on https://en.irct.ir/trial/43493 on 13 November 2019 (13.11.2019) with registration number [IRCT20140307016870N5].

摘要

背景

在重症监护病房中，不当的眼部护理会导致眼部浅层疾病，如角膜溃疡和永久性眼部损伤，这是最常见的并发症之一。本研究旨在评估眼部护理方案的实施对重症监护病房患者感染和眼部浅层疾病发生率的影响。

方法

这是一项交叉临床试验，共纳入 32 名因意识丧失或使用镇静剂后眨眼反射减弱或消失而入住重症监护病房的患者。实验组患者根据方案接受眼部护理，对照组患者接受常规病房护理。数据收集表包括人口统计学和临床信息以及眼部浅层疾病的临床评分量表，每只眼在 7 天内完成。数据分析采用 McNemar 和 Cochran 检验，置信区间为 95%。

结果

在眼部浅层疾病的研究中，对照组和实验组在第 2 至第 7 天的流泪和充血频率无显著差异（P<0.05）。在第 2 至第 3 天，对照组和实验组的干眼症频率无显著差异（P<0.05），但在第 4、5、6 和 7 天有显著差异（P=0.0001）。此外，在第 2 和第 3 天，对照组和实验组的角膜混浊频率无显著差异（P<0.05），但在第 4、5、6 和 7 天有显著差异（P=0.0001）。