中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
3期
259-262
,共4页
郭花%王勤美%俞阿勇%郑景伟%郁继国
郭花%王勤美%俞阿勇%鄭景偉%鬱繼國
곽화%왕근미%유아용%정경위%욱계국
老年人%原发性高血压%白内障%脉压
老年人%原髮性高血壓%白內障%脈壓
노년인%원발성고혈압%백내장%맥압
Aged%Essential hypertension%Cataract%Pulse pressure
目的 研究老年高血压患者白内障术中脉压(PP)变化情况,了解白内障手术的心血管损伤风险.方法 前瞻性对照研究.对2010年11月至2011年3月在温州医学院附属眼视光医院就诊的白内障手术患者,根据高血压和年龄分为3组:其中老年高血压组(A组)21例(21只眼),老年正常血压组(B组)20例(20只眼)和年轻正常血压组(C组)20例(20只眼).测量以下时间点的脉压值:入院时(PP1)、进入手术室术前(PP2)、超声乳化白内障时(PP3)、人工晶状体植入前(PP4)、手术结束时(PP5).同时观察患者术前和术后视力及眼压变化.结果 所有患者均顺利完成手术,术后视力均显著提高(t =-5.692,-4.699,-3.204;P＜0.05),手术前后眼压均在正常范围内,差异无统计学意义(t =1.150,0.214,-0.268;P＞0.05).各时间点脉压依次为:A组(63.00±13.198、77.95±13.08、72.81±17.57、72.81±19.10、73.43±17.98) mm Hg;B组(51.25±10.78、65.10±12.49、65.40±10.18、62.75±12.37、63.25±12.21) mm Hg;C组(37.25±6.74、57.60±13.19、54.50±14.61、53.20±10.01、54.40±12.01) mm Hg.在手术不同时间点,脉压值不同(F=36.161,P＜0.05),3组同一时间点脉压值不同(F =17.277,P＜0.05).PP1从大到小依次为A组、B组、C组(P＜0.05)；A组PP2大于其它组(P＜0.05),B组和C组相似(P＞0.05)；各组PP2比PP1增大(P＜0.05),增大幅度分别为A组(14.59±2.54) mm Hg、B组(13.85±3.16) mm Hg,C组(20.35±3.60) mm Hg,差异均无统计学意义(P＞0.05)；C组PP4测量值低于PP2 (P＜0.05),余差异均无统计学意义(P＞0.05).PP2与年龄、PP1差异有统计学意义(r=0.480,0.565;P＜0.001).结论 白内障手术发生心血管损伤的风险虽然较低,但是高血压是老年人白内障术中发生心脑血管损伤的危险因素.控制并且稳定术前血压、脉压水平,术中心电监护,可降低心血管损伤风险,提高手术安全性..
目的 研究老年高血壓患者白內障術中脈壓(PP)變化情況,瞭解白內障手術的心血管損傷風險.方法 前瞻性對照研究.對2010年11月至2011年3月在溫州醫學院附屬眼視光醫院就診的白內障手術患者,根據高血壓和年齡分為3組:其中老年高血壓組(A組)21例(21隻眼),老年正常血壓組(B組)20例(20隻眼)和年輕正常血壓組(C組)20例(20隻眼).測量以下時間點的脈壓值:入院時(PP1)、進入手術室術前(PP2)、超聲乳化白內障時(PP3)、人工晶狀體植入前(PP4)、手術結束時(PP5).同時觀察患者術前和術後視力及眼壓變化.結果 所有患者均順利完成手術,術後視力均顯著提高(t =-5.692,-4.699,-3.204;P＜0.05),手術前後眼壓均在正常範圍內,差異無統計學意義(t =1.150,0.214,-0.268;P＞0.05).各時間點脈壓依次為:A組(63.00±13.198、77.95±13.08、72.81±17.57、72.81±19.10、73.43±17.98) mm Hg;B組(51.25±10.78、65.10±12.49、65.40±10.18、62.75±12.37、63.25±12.21) mm Hg;C組(37.25±6.74、57.60±13.19、54.50±14.61、53.20±10.01、54.40±12.01) mm Hg.在手術不同時間點,脈壓值不同(F=36.161,P＜0.05),3組同一時間點脈壓值不同(F =17.277,P＜0.05).PP1從大到小依次為A組、B組、C組(P＜0.05)；A組PP2大于其它組(P＜0.05),B組和C組相似(P＞0.05)；各組PP2比PP1增大(P＜0.05),增大幅度分彆為A組(14.59±2.54) mm Hg、B組(13.85±3.16) mm Hg,C組(20.35±3.60) mm Hg,差異均無統計學意義(P＞0.05)；C組PP4測量值低于PP2 (P＜0.05),餘差異均無統計學意義(P＞0.05).PP2與年齡、PP1差異有統計學意義(r=0.480,0.565;P＜0.001).結論 白內障手術髮生心血管損傷的風險雖然較低,但是高血壓是老年人白內障術中髮生心腦血管損傷的危險因素.控製併且穩定術前血壓、脈壓水平,術中心電鑑護,可降低心血管損傷風險,提高手術安全性..
목적 연구노년고혈압환자백내장술중맥압(PP)변화정황,료해백내장수술적심혈관손상풍험.방법 전첨성대조연구.대2010년11월지2011년3월재온주의학원부속안시광의원취진적백내장수술환자,근거고혈압화년령분위3조:기중노년고혈압조(A조)21례(21지안),노년정상혈압조(B조)20례(20지안)화년경정상혈압조(C조)20례(20지안).측량이하시간점적맥압치:입원시(PP1)、진입수술실술전(PP2)、초성유화백내장시(PP3)、인공정상체식입전(PP4)、수술결속시(PP5).동시관찰환자술전화술후시력급안압변화.결과 소유환자균순리완성수술,술후시력균현저제고(t =-5.692,-4.699,-3.204;P＜0.05),수술전후안압균재정상범위내,차이무통계학의의(t =1.150,0.214,-0.268;P＞0.05).각시간점맥압의차위:A조(63.00±13.198、77.95±13.08、72.81±17.57、72.81±19.10、73.43±17.98) mm Hg;B조(51.25±10.78、65.10±12.49、65.40±10.18、62.75±12.37、63.25±12.21) mm Hg;C조(37.25±6.74、57.60±13.19、54.50±14.61、53.20±10.01、54.40±12.01) mm Hg.재수술불동시간점,맥압치불동(F=36.161,P＜0.05),3조동일시간점맥압치불동(F =17.277,P＜0.05).PP1종대도소의차위A조、B조、C조(P＜0.05)；A조PP2대우기타조(P＜0.05),B조화C조상사(P＞0.05)；각조PP2비PP1증대(P＜0.05),증대폭도분별위A조(14.59±2.54) mm Hg、B조(13.85±3.16) mm Hg,C조(20.35±3.60) mm Hg,차이균무통계학의의(P＞0.05)；C조PP4측량치저우PP2 (P＜0.05),여차이균무통계학의의(P＞0.05).PP2여년령、PP1차이유통계학의의(r=0.480,0.565;P＜0.001).결론 백내장수술발생심혈관손상적풍험수연교저,단시고혈압시노년인백내장술중발생심뇌혈관손상적위험인소.공제병차은정술전혈압、맥압수평,술중심전감호,가강저심혈관손상풍험,제고수술안전성..
Objective To evaluate senior hypertensives' cardiovascular system by pulse pressure (PP) in cataract surgeries. Methods Prospective and case control study.Sixty-one cataract patients were settled to group A (aged,hypertensives),group B(aged,normoten-sives) or group C (middle-aged,normotensive).PP measurements were recorded on the day they were hospitalized as baseline (PP1),just before surgeries started (PP2),during phcaoemulsification (PP3),before intraocular lens implantation (PP4),and at the endpoint of the surgeries (PP5).In addition,best corrected visual acuity (BCVA) and intraocular pressures (IOPs) were investigated. Results All patients got an improvement in BCVA after surgery and IOPs were within normal levels.PPl～5 measurements were as follows respectively,(63.00± 13.198,77.95± 13.08,72.81± 17.57,72.81± 19.10,73.43± 17.98) mmHg in group A; (51.25±10.78,65.10±12.49,65.40±10.18,62.75±12.37,63.25±12.21) mmHg in group B,and (37.25±6.74,57.60±13.19,54.50±14.61,53.20±10.01,54.40±12.01) mmHg in group C.There were significant differences in PP1 measurements among groups (P ＜0.05).PP2 measurement in group A was the highest (P ＜0.05),whereas,no significant difference was found in measurements between group B and C (P ＞0.05).The increases in PP2 measurements were (14.59±2.54,13.85±3.16,and 20.35±3.60) mmHg,respectively.And no significant difference was found in the increase of PP2 or measurements of PP2～5 among groups.There was a significant correlation of PP1～5 measurements within groups (F =36.161,P ＜0.001).And no significant difference was found in the main effects among groups (F =0.939,P ＞0.05). Conclusions This prospective analysis shows that cataract surgery is safe despite being performed in an elderly population.The high levels of PP has important roles in the risk of organ damage to senior hypertensives and measures should been taken in controlling PP for the sake of safety in cataract surgery.
