Chitosan Membrane Application In The Neurosurgical Anesthesia Surgery Eye Care Research

Background: The operating room,operating room English O.R)is to provide patients with surgery and rescue sites,is one of the important department of hospital.With the rapid development of surgical techniques,operatingroom work increasingly modernization and humanization and details.Operation process not only to solve the symptoms,disease patients and their families also pay more and more attentionto feelings and the quality of life after surgery.And exposure keratitis(also known as rabbit eyes keratitis)is one of the common complications after general anaesthesia,often leading to cannot be closed or closed eyelids diseases and external factors can cause of exposure keratitis,its performance for patients with postoperative photophobia,tears,blurred vision,foreign body sensation,symptoms such as pain discomfort.Once the symptoms occur,if the treatment is not easy to cause secondary infection caused by corneal ulcer and even left permanent vision impairment caused by blindness.Atpresent there are a few foreign research involved in this field,in whichfew research has explored the neurosurgical anesthesiasurgery in the bestway to eye care;Domestic few similar studies and will not be able to provide powerful evidence.Check the literature information learned that by far the most common eye care scheme is applied antibiotic eye ointment local post again after polyethylene film.This field are given basedon evidence-based reliable evidence is not much,the lack of standardizedclinical nursing standards,the study analysis ofneurosurgery in investigation the status quo of eye care intervention in the process of general anesthesia surgery combined with my current applications of chitosan membrane eyecare new technology products,has formed two kinds of eye care intervention program,through randomized controlled design,the application of chitosan membrane eye and eye care of present conventional methods such as using erythromycineye ointment besmear after eye covered with vaseline gauze with 3 l paste the drapes sealed lid split method in protecting the eye,to explore more effective to reduce intraoperative exposure keratitis and its complications of eye care intervention method,expected to provide more evidence for clinical nursing practice,to develop scientific,effective,practical,easy to offer reference to the general anesthesia surgery of eye care routine.Objective: To understand the present situation of general anesthesia surgery ofeye care intervention,on the basis of comparison and evaluation of the neurosurgical anesthesia surgery patients in intraoperative application of two methods of eye care intervention on the advantages and disadvantages.And the prevention of post-operative exposure keratitis severity and its complications such as conjunctival redness,blurred vision,photophobia,tears,pain and discomfort,the effect of the foreign body sensation,sticky feeling,etc.Method:His topic will be from January 1,2016 the solstice September31,the neurosurgical anesthesia surgery in our hospital operating room,a total of 100 cases of eligible patients,according to the method of randomdivided into 2 groups,the observation group of 50 cases,control group50 cases,observation group using chitosan membrane eye stick I-E(sino-foreign joint venture handan warren more science and technology development co.,LTD.,production,drug safety in food machinery production xu,20150077)and transparent polyethylene film on;Control group using erythromycin eye ointment(posterior to proper use sterile vaseline gauze to cover,reoccupy sterile 3 l paste the drapes were applied.Observe the postoperative incidence of exposure keratitis in 24 to 48 hours.1 Preoperative-each patient were not in the near future eye disorders such as cornea,conjunctiva,no eyelid injury;and eliminate eye complications possibility of diseases such as diabetes,elimination of erythromycin eye ointment allergy;excluded patients with pregnancy,lactation,ruled out important organs such as liver and kidney lung injury and intraoperative intolerance surgery patients,postoperative follow-up of patients were soberand in 24 hours in a stable condition,can answer questions independently,good treatment adherence to.Two groups of patients inage,sex,length of time of surgery,total input liquid of no statistical significance(P> 0.05).The position as a result of the surgery will also affect the results of the study,the sample adopt to pillow for the patient supine,head pad under the silica gel circle fixed head,intraoperative surgical bed reduce does not exceed 30 degrees.Methods(1)The control group using erythromycin eye ointment besmear in posterior by 3 l paste with vaseline gauze to cover the seal theeyelid surgery wipes the paster.Of erythromycin eye ointment to use: after general anesthesia induction to wash your hands when the operator daub quick-drying from detergent to wash your hands,stay with lower eyelids open the left thumb of patients after dry,will be a moderate amount of erythromycin eye ointment(someone special,prevent cross infection)in lower eyelid conjunctiva sac,top-down vaseline gauze accessories cover again,in the eyelids is a little hard to ensure that the doubleeyelids closed completely.Then cut out good 3 l paste the drapes covered in oil on the yarn,reserved around the same width.Gently squeeze around the oil gauze with tampon and to make the paste firmly withoutaperture.Stop muscle relaxant 20 minutes with a sterile gauze to gentlyclean eye 0.9% sodium chloride solution,prevent due to viscous oculentum affect patients in the wake of him only.2 experimental group usingchitosan membrane eye care intervention.For patients with general anesthesia induction,the operator wash your hands after applying speed dry hand sanitizers.After being dried to chitosan gel mask get removed from the packaging from top to bottom(smooth surface toward the eye)were applied in patients with eye,use the product weight to make doubleeyelid closure,make the patients eyes in product transparent part centerensure the eye is located at the central.The sticker by intermediate cutting place to peel off on both sides of the surface of the plastic film,extract product on both sides of the handle part fixed in the eye film surface pay attention to four weeks to return the same width.Then stripped,the upper plastic film with acotton ball gently around the eye film extrusion to ensure pasted firmly without aperture.After surgery,peel off gently eye film.2 Within 24 hours after being awake in patients with postoperativeof using chitosan membrane eye of patients and patients with eye protection for return visit to the conventional methods,observation and ask patients have eyes without conjunctival congestion,viscous,discomfort,pain,photophobia,foreign body sensation,symptoms such as performance.Please ophthalmology consultation at the same time,be eye slit lamp examination corneal lesions:mild falls off for corneal epithelium,corneal a dot turbidity,swelling and pupil normal conjunctival congestion;Moderate for stromal infiltration,and the corneal epithelium on the pupil dotturbid degree of involvement and less than or equal to 1/2;Severe corneal ulcer,edema,corneal epithelium damage limitations.Results:1 The observation group and control group in terms of interference factors such as age,gender,length of time of surgery,the respect such as the input amount of liquid by t test P values > 0.05,will not affectour research results,no statistical significance.2 The review result after 24 hours,1,in the aspect of corneal injury severity: no symptoms in 47 patients with postoperative observationgroup,mild corneal epithelium shedding in 2 cases,1 cases of stromal infiltration,corneal ulcer 0 cases,the incidence is 6%;The control group in patients with postoperative asymptomatic 42 cases,mild corneal epithelium shedding 7cases,stromal infiltration in 4 cases,2 cases of corneal ulcer,the incidence is16%;2,in the eye of postoperative complications in observation group 1conjunctival redness and swelling,pain,discomfort in 2 cases,1 cases of blurred vision,2 cases,foreign body sensation,viscous 1 cases,photophobia,tears 3 cases;Control group 4 cases were conjunctival redness and swelling,pain,discomfort in 5 cases,6 cases of blurred vision,6 cases of foreign body sensation,viscous feeling 7 8,photophobia,tears.With conjunctival inflammation group data on the subjective symptoms,pain,discomfort groupdata,foreign body sensation,data group(P< 0.05),blurred vision,viscous sense data,photophobia,tears group data and objective examination corneal disease severity in three groups data(P< 0.01)has a great deal of statistical significance.Conclusion : In view of the general anesthesia patients intraoperative neurosurgery eye care research,has yet to form effective based on the unification of the evidence of evidence-based practice.In combination with review of the literature and this study used.The two kinds of eye although intervention can effectively relieve eye exposure to general anesthesia in neurosurgery operation.Keratitis severity and eye complications,but the use of medical chitosan membrane eye can more effectively protect the eyes,improve patient comfort and postoperative quality of life and satisfaction,shorten hospitalization time,saves the cost of hospitalization.Chitosan membrane eye stick for neurosurgery patients with general anesthesia surgery of eye protection provides a more convenient,safe,effective and reliable solution.