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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二层,第三层,第四层,第五层,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二层,第三层,第四层,第五层,*,*,晶状体在眼球内的位置,(Position of Lens in the Eye),2024/11/12,1,晶状体在眼球内的位置,2024/11/12,2,2023/8/112,广义上讲,任何因素导致晶体,(lens),出现浑浊都可称为白内障。,Disease Description,2024/11/12,3,Disease Description 2023/8/113,白内障国情,(,National Conditions,),1.6000,万,(sixty million),白内障患者,2.100,万,(one million),白内障患者应施行手术,3.,每年新增患者,40,万,(,four hundred thousand,),4.,人口老龄化,患者逐年增加,白内障治疗、,护理任务项繁重,(A,burdensome,task),2024/11/12,4,2023/8/114,白内障临床分类,(,Classification of Clinic,),2024/11/12,5,白内障临床分类,一:,Senile Cataract,si:nail,年龄相关性白内障,(,age-related cataract,),2024/11/12,6,一:Senile Cataract,二:,Traumatic Cataract,tr:mtik,外伤性白内障,:,眼球穿孔伤、钝挫伤,2024/11/12,7,二:Traumatic Cataract,三:,Metabolic Cataract ,metblik,代谢性白内障:糖尿病,甲状腺疾病,2024/11/12,8,2023/8/118,四,:,Congenital Cataract kndenitl,先天性白内障,2024/11/12,9,四:Congenital Cataract k,五:,Medicamentous Cataract,药物性中毒性白内障:长期使用“类固醇”药物,六:,Radiated Cataract,reidieitid,辐射性白内障:因放射线所致,2024/11/12,10,五:Medicamentous Cataract2023/,老年性白内障,Senile Cataract,2024/11/12,11,老年性白内障 Senile Catara,1.,年龄增长,晶状体逐渐混浊,即为老年性白内障。一般起于,40,45,以后,2.,主要病因,:,氧化损害,(Oxidative Damage)ksideitiv,3.,临床表现,:,眼前阴影和渐进性、无痛性视力减退,(Visual Deterioration)di,tirirein,2024/11/12,12,1.年龄增长,晶状体逐渐混浊,即为老年性白内障。一般起于40,Nursing Assessment,(,一,)Health History,1.,年龄,(Age),2.,外伤,(Trauma),3.,营养,(Nutrition),4.,遗传,(Heredity)hirediti,5.,代谢,(Metabolize)mtblaiz,6.,全身病,(General Disease),2024/11/12,13,Nursing Assessment(一)H,身体状况,(Physical Condition),1.,症状,(Symptom),渐进性视力下降,(Gradual Visual Deterioration,),di,tirirein,2024/11/12,14,身体状况 (Physical C,皮质性白内障,Clinical Stages,初期,(,Initial Stage,),1,、无视力下降(对视力无影响),2,、皮质内出现空泡,水裂和板层分离,,从周边逐渐向中央扩大,呈“羽毛状”或,楔形浑浊,3,、此期发展缓慢,可经数年,2024/11/12,15,皮质性白内障Clinical Stages,2024/11/12,16,2023/8/1116,膨胀,期,(Dilatational Stage),1.,视力下降,2.,晶体呈不均匀浑浊,3.,晶体体积变大,将虹膜向前推移,4.,前房变浅,5.,诱发急性闭角型青光眼,AACG:,(,Acute Angle Closure Glaucoma),2024/11/12,17,2023/8/1117,2024/11/12,18,2023/8/1118,三期:成熟期,(Maturity Stage),mtjuriti,1.,视力下降至眼前手动,/,光感,2.,晶体灰白色均匀浑浊,3.,虹膜投影消失,4.,眼底不能窥入,2024/11/12,19,2023/8/1119,2024/11/12,20,2023/8/1120,四期:过熟期,(Overripe Stage)uvraip,1.,视力突然提高,(,晶体皮质液化,外溢,核下沉,),2.,前房加深,3,.,虹膜震颤,4.,浑浊晶体纤维分解液化,呈乳白色,5.,棕黄色晶体核下沉于囊袋下方,6.,诱发晶体溶解性青光眼,2024/11/12,21,2023/8/1121,2024/11/12,22,2023/8/1122,Physical Sign,白瞳症,(White Pupil),是最明显的体征,2024/11/12,23,Physical Sig,Nursing Diagnosis,1.,感知改变,(Perceptual Alteration),2.,自理缺陷,(Self Care Deficit),3.,受伤危险,(Risk for Injury),4.,知识缺乏,(Knowledge Deficit),5.,潜在并发症,(Potential Complications),2024/11/12,24,Nursing Diagnosis 1.感知改变(Perc,Nursing Goals,1.,病人视力提高,2.,自理恢复,3.,避免受伤,4.,熟悉相关知识,5.,避免并发症,2024/11/12,25,Nursing Goals 1.病人视,Nursing Interventions,一般护理,(Ordinary Providence),1.,病房介绍,(Ward,Introduction),2.,饮食指导,(,D,iet,Guidance),2024/11/12,26,Nursing Interventions,治疗配合,一:药物护理,(1),维生素类,VitC,VitB2,(2),滴眼液,:,白内停,谷胱甘肽,卡他灵,二:手术治疗,2024/11/12,27,治疗配合 一:药物护理2023/8/1,2024/11/12,28,2023/8/1128,手术前准备,1.,抗生素眼液 术前,3,天,2.,镇静剂,3.,冲洗结膜囊,4.,冲洗泪道,5.,降眼压,Intraocular Pressure ,intrkjul,6.,散瞳孔,2024/11/12,29,手术前准备1.抗生素眼液 术前3天2023/8/1129,2024/11/12,30,2023/8/1130,2024/11/12,31,2023/8/1131,2024/11/12,32,2023/8/1132,术后护理,一:“四位”一体,(Four Positions),1.,体位,(Body),2.,头位,(Head),3.,口位,(Mouth),4.,手位,(Hand),白内障,超声,乳化,+,人工,晶体,植入,术,绝对安静,仰卧位,2,3,天有前房,出血时,,宜取半卧位,防,止血,液流入,玻璃,体内。,二:预防感染,(Infection Prevention),氧氟沙星滴眼液,三:定期复查,(Regularl Countercheck),one week,one month,,,six months,2024/11/12,33,术后护理一:“四位”一体(Four Positions),二:预防感染(Infection Prevention),氧氟沙星滴眼液,三:定期复查 一周,一个月,六个月,2024/11/12,34,二:预防感染(Infection Prevention)2,先天性白内障,病因,:,有内源性和外源性两种,内源性与染色体基因有关,有遗传性。外源性是指母体孕期及胚胎发育期异常患病(妊娠三个月内患病毒性感染、甲状腺机能不足、营养不良、维生素缺乏等)对晶体造成的损害。,先天性白内障病因:有内源性和外源性两种,内源性与染色体基,
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