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Jingdong book

白内障手术筛查及护理读本

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Books Medical Science Ophthalmology

Jingdong book

白内障手术筛查及护理读本

Name: 白内障手术筛查及护理读本
Brand: Jingdong book
SKU: 3117127861
Price: 21.98 USD
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本书通俗易懂，内容简洁、科学实用，既可供全科医师白内障手术筛查时参考学习，同时也有利于白内障手术患者了解相关知识，以便更好地配合白内障手术的各项检查、准备和护理。

Content Description

本书包括白内障手术的基础理论、检查、手术技术、患者术前注意及术后护理等。

Author Description

张旭东，眼科副主任医师。中国共产党党员，“全国新长征突击手”。从事眼科临床工作40余年，内蒙古自治区视力残疾人康复专家组成员。现每年仍主刀完成约1500例白内障复明手术。已出版《老年眼病的防治》《糖尿病·糖尿病眼病的科学防治》《实用眼科学》及《实用眼科知识大全》等专著。先后在眼科杂志发表论文30余篇。韩宇，复旦大学附属眼耳鼻喉科医院干部保健特需病区护士长，主管护师。上海护理学会委员，农工党复旦大学附属眼耳鼻喉科医院支委副主委。参编大专院校眼耳鼻喉科教材及《实用眼科学》《眼耳鼻喉疾病的食疗保健》及《实用眼科知识大全》等专著。在核心期刊发表多篇论文，主持上海市卫生局青年基金课题一项。

Catalogue

第一章总论

第一节防盲治盲、扶贫白内障手术的意义

第二节中华健康快车的由来和简介

第三节香港回归之际健康快车开行

第四节健康快车运作方式

第二章白内障手术筛查（全科医师篇）

第一节眼的解剖与生理

第二节白内障的基本知识

第三节白内障手术筛查的内容与方法

第四节白内障手术知识

第五节白内障术后并发症

第三章白内障手术须知（患者篇）

第一节术前谈话与医患沟通

第三节术前个人准备

第四节术中配合

第五节白内障手术后护理

第六节术后复查和随访

附1 白内障复明手术知识

附2 健康快车白内障患者术后须知

附3 健康快车白内障患者出院指导

附4 健康快车白内障患者出院征求意见表

结语

致健康快车

Book Abstract

第二节白内障的基本知识

一、认识白内障

无论什么原因，只要晶状体发生变性和混浊，变成不透明，甚至影响视力，就称为白内障。白内障是常见的致盲性眼病。人眼中有一个组织叫作晶状体，就像照相机的镜头，正常情况下它是透明的，光线通过它及一些屈光间质到达视网膜，才能清晰地看到外界物体。一旦晶状体由于某些原因发生混浊就会影响视网膜成像，使人看不清东西。也就是说，晶状体混浊导致视力下降就是白内障。最常见的为老年性白内障，60岁以上的人群中，半数以上患有不同程度的白内障。在我国白内障是致盲的第一病因。

二、白内障发生的原因

1老年性白内障是老年人常见的眼部疾病之一，因为年龄增长，身体器官（晶状体）老化，营养代谢下降，体内维生素C缺失而导致晶状体营养代谢障碍。

此外，由于长期紫外线的伤害及组织的老化、内分泌紊乱（糖尿病性白内障）导致晶状体变硬而混浊，最早的在40岁以后即可发生。由于晶状体pH的改变及房水渗透压、化学成分改变，而导致晶状体核硬化、脱水混浊。

2先天性白内障可能因为遗传因素或者是胎儿时期受到感染，在出生时即已发生晶状体混浊；也有晶状体先天异常（如球形晶状体、圆锥晶状体等）。

3外伤性白内障眼睛受伤也可造成白内障，如撞击、穿刺伤、电击、高热、化学药品灼伤等，皆可能伤及晶状体。

4继发性白内障可继发于眼疾或全身性疾病，如青光眼、虹膜睫状体炎、糖尿病等，或是受某些特定的感染、药物诱导，如皮质激素等。

5辐射性白内障有大剂量放射线接触史。

三、白内障有哪些症状

白内障早期几乎没有什么症状，不痛不痒，不红不肿，视力会在一段时间内逐渐下降，自觉视力模糊，眼前似有一层白雾，看东西灰蒙蒙的，对精细的东西分辨不清；还会有眼前出现固定不动的黑点的现象，称作飞蚊症（图2-6）；最多的情况是看东西变形或重影，夜间看月亮可看到2~3个。

图2-6飞蚊症

配戴眼镜镜片处方度数会显示经常性的变化。如果在阳光下或强光下，会有特别刺眼、明显视力模糊或眼前出现固定不动的暗点的感觉，同时眼睛颜色看起来不鲜明或呈棕黄色。随着白内障的发展，视力进行性下降。到双眼成熟期甚至只能分辨白天和黑夜，视力可降至005以下，甚至手动或光感。

四、白内障对视力的影响

晶状体在眼的屈光系统中占有很重要的地位。当晶状体开始混浊时，患者可以很快从视觉上察觉到，眼前有点状或短线状阴影，随眼球转动，类似玻璃体混浊时的飞蚊症。不同之处在于，玻璃体混浊往往在眼球停止转动时阴影还在运动，且混浊阴影的形态常有改变。晶状体核硬化或晶状体脱位时，可出现单眼复视，把一个东西看成两个。晶状体纤维缝隙处发生水化现象，形成透明裂隙时，将晶状体分为两个或多个清亮区，因而把一个灯光、月亮或其他东西看成两个或多个（单眼视力）。晶状体混浊的早期，常出现屈光力增加，使该眼变成近视状态，本来戴老视镜的人这时不戴眼镜反而看得更清楚了，但是，在近视力一度好转的同时，远视力相应减退，随着晶状体混浊的发展，最终远近视力都发生了障碍（图2-7）。

图2-7白内障患者视差图

上述这些症状，也有许多患者不曾察觉，只主诉视力逐渐模糊。甚至单眼所患白内障已近成熟期仍未察觉，只在偶尔盖住健眼时，才发现病眼看不到东西。

白内障对视力的影响程度，还要看混浊部位和混浊程度。晶状体内点状的、分立的、周边的，甚至播散的混浊，对视力可无大的影响。若为弥散性而位于中央部的混浊，对视力的影响则较明显。后极性或核性位于中央部的混浊，在阳光下瞳孔缩小，视力最差，可能走路都感到困难，而在较暗处或弱光下，瞳孔开大，晶状体周边部光线可以通过，仍会有较好的视力，甚至能阅读书报。周边楔状混浊，楔间皮质清亮，在亮处不太影响视力，而在暗处则视力较差。单晶状体前极部的混浊，不影响光线通过，一般不影响视力。晶状体全混浊后，视力降到手动或光感，若无其他并发症，光感是不会消失的。

……

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