摘要目的：总结儿童配戴角膜塑形镜的不良反应的原因及护理对策,以提高治疗疗效,减少不良反应的发生。方法选取2013年5月—2014年6月验配角膜塑形镜并能按时复查的1066例患儿,对发生角膜点染、偏位及重影、配戴不舒适感的原因进行分析,并给予相应的护理措施及健康宣教。结果1066例配戴角膜塑形镜6个月内患儿角膜上皮点染发生350例,占32.8%,多数于戴镜1个月内出现,给予左氧氟沙星滴眼液、玻璃酸钠滴眼液及贝复舒凝胶滴眼,停戴1周并进行相应的健康宣教,1周后复查,角膜上皮细胞修复、点染消失。偏位发生170例,占16%。2例患儿由于镜片偏位滑落到结膜囊,家长在专业护士的指导下取出镜片。重影128例,占12%。234例患儿戴镜后出现不适感,占22%。所有患儿均未发生角膜不可逆损伤及眼部感染。结论针对儿童配戴角膜塑形镜不良反应的原因采取相应护理对策和健康宣教可以提高儿童配戴角膜塑形镜的成功率,延长角膜塑形镜使用寿命和改善治疗效果,减少不良反应的发生。

abstractsObjective To summarize the observation and nursing strategy of side effects for children wearing Ortho-K contact lens in order to improve the effects of treatment and reduce side effects. Methods A total of 1 066 myopic children wearing Ortho-K CL, who could recheck on time in Beijing Children′s Hospital from May 2013 to June 2014 were included. The reason of dyed cornea, dislocation, and discomfortable were analyzed, and corresponding nursing and healthy propaganda were performed. Results Among 1 066 children, 350 children (32. 8% ) wearing Ortho-K CL had epithelial dyed cornea after 6 months, and most of them appeared 1 month after wearing the lens. It would disappear after the treatment by levofloxacin eye drops, sodium hyaluronate eye drops and recombinant bovine basic fibroblast growth factor gel, stopping using the Ortho-K contact lens and providing healthy progaganda after 1 week. A total of 170 children (16% ) wearing Ortho-K CL had dislocation, in which 2 children slipped into conjunctival sac and it was taken out under guidance of nurse by parents. A total of 128 children (12% ) suffered from diplopia after wearing the lens, and 234 children(22% ) wearing Ortho-K CL had discomfortable feeling. No children had irreversible impairment and ocular infection. Conclusions According to the reason of side effects, appropriate nursing strategy and healthy propaganda can improve the success rate of Ortho-K contact lens, prolong their service time, contribute treatment effectiveness, and reduce its side effects.