基础麻醉在配合度差的老年白内障患者超声乳化手术中的应用
发布时间：2018-02-13 12:06
本文关键词： 老年痴呆 智力低下 聋哑 白内障超声乳化手术 基础麻醉 出处：《眼科新进展》2015年03期 论文类型：期刊论文
【摘要】：目的探讨表面麻醉联合基础麻醉下超声乳化术对配合度差(老年痴呆、智力低下、聋哑)的老年白内障患者的手术安全性,并观察术后并发症、最佳矫正视力、血液流变学及泪膜稳定性的变化情况。方法选取64例(87眼)老年痴呆、智力低下、聋哑老年白内障患者,随机分为A、B两组。A组在表面麻醉下行白内障超声乳化+人工晶状体植入术;B组采用表面麻醉复合基础麻醉下行白内障超声乳化+人工晶状体植入术。术前、术中及术后2周观察最佳矫正视力、术后并发症、血液流变学及泪膜稳定性情况。结果A组患者麻醉效果Ⅲ级22眼,B组患者Ⅲ级5眼,两组差异有统计学意义(χ2=0.000,P0.05);两组术前最佳矫正视力、心率、舒张压和收缩压、泪膜破裂时间(break up time,BUT)、基础泪液分泌试验(Schirmer I test,SIT)差异均无统计学意义(均为P0.05),术中两组患者心率、舒张压和收缩压相比差异均有统计学意义(t心率=9.158,t收缩压=8.552,t舒张压=7.259,均为P0.05);术后2周两组患者最佳矫正视力相比差异有统计学意义(P0.05),而BUT及SIT差异均无统计学意义(均为P0.05)。B组手术时间(18.6±3.5)min明显比A组(26.8±7.2)min短,两组比较差异具有统计学意义(t=6.524,P0.05);对比两组术后并发症,A组有12眼(27.27%),B组有5眼(11.63%),A组并发症发生率明显高于B组,两组差异具有统计学意义(χ2=4.268,P0.05)。结论对配合度差的老年白内障患者(如老年痴呆、智力低下、聋哑)实施超声乳化手术时,选用表面麻醉联合基础麻醉能在术中获得更好的麻醉效果,提高患者的视觉质量,值得临床推广应用。
[Abstract]:Objective to investigate the surface anesthesia combined with basal anesthesia phacoemulsification on the matching degree of difference (senile dementia, mental retardation, deaf) operation safety of senile cataract patients, and postoperative complications, visual acuity, changes in blood rheology and stability of tear film. Methods 64 cases (87 eyes) of senile dementia the deaf, mental retardation, senile cataract patients were randomly divided into A group, B two group.A in the downlink of phacoemulsification and intraocular lens implantation with topical anesthesia; group B with surface anesthesia general anesthesia in phacoemulsification and intraocular lens implantation. Preoperative best corrected visual acuity were observed during and after the operation of 2 weeks, postoperative complications, blood rheology and tear film stability. Results A group of patients with anesthesia of 22 eyes, 5 eyes of patients in the B group, there was significant difference between two groups (2=0.000, P0.05); the two groups preoperative best corrected 姝ｈ鍔，
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