雷射屈光手術之手術全期護理

Peri-operative Nursing Care of Patients Undergoing Refractive Surgery

雷射屈光手術近幾年已成為台灣廣大近視族群的熱門話題，雖然只有十年光景，但由於角膜板層手術與準分子雷射的完美結合，造福了全世界眼鏡族群。本文介紹目前治療近視之準分子雷射屈光手術，包括雷射屈光角膜切削術(Photorefractive Keratectomy, PRK)及雷射層狀角膜重塑術(Laser in situ Keratomileusis, LASIK)，兩者均為即日手術(ambulatory surgery)，整體手術過程只需數分鐘，經由手術全期護理模式的運用在手術前、中、後期間，提供病人高品質之照護，內容包括在術前提供醫療訊息，滿足病人個別性的需要、緩解焦慮，術中注重手術部位辨識、手術設備確認以維護病人安全、避免感染及給予心理支持，術後立即期的照護包括監測生命徵象及觀察術後傷口與出院後之需求，持續患眼監測及指導居家自我照護，有助於護理人員於有限的時間內提供有組織、有效率的護理照護。

Recently, excimer refractive surgeries have become popular procedures for correcting myopia, hyperopia and astigmatism in Taiwan. The optimal combination of lamellar keratectomy and excimer laser can provide satisfactory results. This article introduced photorefractive keratectomy (PRK) and the Laser in situ keratomileusis (LASIK) that are categorized as ambulatory surgery. Within the short operation period, nurses should provide preoperative health care information to relieve patient anxiety, maintain patient safety and infection precaution during operation, and provide postoperative monitoring and self-care instructions. The application of perioperative nursing principles contributes to delivering organized and effective patient care in a limited timeframe.