Yang Suling, Guo Weina, Gong Yuexing, Wang Jiancang, Chen Lu, Zhao Jingcong, Guo Xiting, Bai Jie, Song Yanxia
Department of Ophthalmology, Children's Hospital of Hebei Province, Shijiazhuang, China.
Department of Ophthalmology, Logistic Support Forces of the Chinese People's Liberation Army 980 Hospital, Shijiazhuang, China.
Transl Pediatr. 2021 Sep;10(9):2335-2346. doi: 10.21037/tp-21-385.
After strabismus surgery, the local swelling of conjunctival wound will affect the uniform distribution of tears on the ocular surface, and the inflammatory reaction will affect the stability of tear film, which will easily lead to iatrogenic dry eye. This study aimed to investigate the effect of vitamin A palmitate (VAP) eye gel application in dry eye and the advantages of Watson's theory of caring.
Two hundred and forty children with dry eye after strabismus surgery treated in our hospital from September 2018 to September 2020 were selected as the study subjects, and were randomly divided into control group and observation group according to the allocation ratio of 1:1. Watson's theory of care nursing was applied in the observation group, and VAP eye gel was additionally dropped into the eye. Mouse conjunctival goblet cells (GCs) were used to detect the effect of VAP on the growth of GCs. Treatment compliance, improvement of dry eye symptoms [Schirmer I test (SIT), tear film break-up time (BUT), and fluorescent staining (FL) score], inflammatory factor levels in tears, clinical efficacy, and parents' satisfaction were compared.
It was found that VAP eye gel could better promote the proliferation of GCs. After nursing and clinical treatment, the dry eye symptoms were improved in all included children, and improvements in the SIT, BUT, and FL scores were more obvious in the observation group. Watson's theory of care nursing could effectively improve the children's treatment compliance and parents' satisfaction.
As a result, the application of VAP eye gel and Watson's theory of care nursing could effectively reduce the occurrence of dry eye after strabismus surgery, and were of great importance for improving the relationship between nurses and patients and building a harmonious hospital.
Chinese Clinical Trial Registry ChiCTR2100049136.
斜视手术后，结膜伤口局部肿胀会影响泪液在眼表的均匀分布，炎症反应会影响泪膜稳定性，易导致医源性干眼。本研究旨在探讨应用维生素A棕榈酸酯（VAP）眼凝胶对干眼的影响以及华生关怀理论的优势。
选取2018年9月至2020年9月在我院接受治疗的240例斜视手术后干眼患儿作为研究对象，按1∶1分配比例随机分为对照组和观察组。观察组应用华生关怀理论护理，并额外滴入VAP眼凝胶。采用小鼠结膜杯状细胞（GCs）检测VAP对GCs生长的影响。比较两组患儿的治疗依从性、干眼症状改善情况[泪液分泌试验（SIT）、泪膜破裂时间（BUT）及荧光素染色（FL）评分]、泪液中炎症因子水平、临床疗效及家长满意度。
发现VAP眼凝胶能更好地促进GCs增殖。经过护理及临床治疗，所有纳入患儿的干眼症状均有改善，观察组SIT、BUT及FL评分改善更明显。华生关怀理论护理能有效提高患儿治疗依从性及家长满意度。
因此，应用VAP眼凝胶及华生关怀理论护理可有效降低斜视手术后干眼的发生，对改善护患关系、构建和谐医院具有重要意义。
中国临床试验注册中心ChiCTR2100049136。
