中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
33期
19-20,21
,共3页
小切口%白内障摘除术%麻醉
小切口%白內障摘除術%痳醉
소절구%백내장적제술%마취
Small incision%Cataract extraction%Anesthesia
目的：探讨小切口非超声乳化白内障摘除术中,根据患者配合程度及术眼情况合理选择不同的麻醉方式的临床效果。方法1752眼行小切口非超声乳化白内障摘除手术中,1416眼(80.82%)采用单纯表面麻醉；因耳聋、紧张不能配合手术者314眼(17.92%)采用表面麻醉联合球结膜下麻醉；青光眼术后或有虹膜粘连、小瞳孔、晶体半脱位等情况22眼(1.26%)采用球周麻醉。记录手术前后的视力,手术时间,观察麻醉效果及术中术后并发症。结果术后1个月最佳矫正视力≥0.5者1528眼(87.21%),手术平均时间(9.25±4.11)min,术中无明显不适1372眼(78.31%)；有胀痛感380眼(21.69%)。术中并发症：后囊破裂13眼(0.74%),悬韧带局部断裂4眼(0.23%)。术后并发症：角膜水肿138眼(7.88%),一过性高眼压31眼(1.77%),眼内炎2眼(0.11%)。结论小切口非超声乳化白内障摘除术中根据患者情况合理选择麻醉方式,有助于手术的安全、顺利实施。
目的：探討小切口非超聲乳化白內障摘除術中,根據患者配閤程度及術眼情況閤理選擇不同的痳醉方式的臨床效果。方法1752眼行小切口非超聲乳化白內障摘除手術中,1416眼(80.82%)採用單純錶麵痳醉；因耳聾、緊張不能配閤手術者314眼(17.92%)採用錶麵痳醉聯閤毬結膜下痳醉；青光眼術後或有虹膜粘連、小瞳孔、晶體半脫位等情況22眼(1.26%)採用毬週痳醉。記錄手術前後的視力,手術時間,觀察痳醉效果及術中術後併髮癥。結果術後1箇月最佳矯正視力≥0.5者1528眼(87.21%),手術平均時間(9.25±4.11)min,術中無明顯不適1372眼(78.31%)；有脹痛感380眼(21.69%)。術中併髮癥：後囊破裂13眼(0.74%),懸韌帶跼部斷裂4眼(0.23%)。術後併髮癥：角膜水腫138眼(7.88%),一過性高眼壓31眼(1.77%),眼內炎2眼(0.11%)。結論小切口非超聲乳化白內障摘除術中根據患者情況閤理選擇痳醉方式,有助于手術的安全、順利實施。
목적：탐토소절구비초성유화백내장적제술중,근거환자배합정도급술안정황합리선택불동적마취방식적림상효과。방법1752안행소절구비초성유화백내장적제수술중,1416안(80.82%)채용단순표면마취；인이롱、긴장불능배합수술자314안(17.92%)채용표면마취연합구결막하마취；청광안술후혹유홍막점련、소동공、정체반탈위등정황22안(1.26%)채용구주마취。기록수술전후적시력,수술시간,관찰마취효과급술중술후병발증。결과술후1개월최가교정시력≥0.5자1528안(87.21%),수술평균시간(9.25±4.11)min,술중무명현불괄1372안(78.31%)；유창통감380안(21.69%)。술중병발증：후낭파렬13안(0.74%),현인대국부단렬4안(0.23%)。술후병발증：각막수종138안(7.88%),일과성고안압31안(1.77%),안내염2안(0.11%)。결론소절구비초성유화백내장적제술중근거환자정황합리선택마취방식,유조우수술적안전、순리실시。
Objective To investigate the clinical effects of different anaesthesia methods in small incision non-phacoemulsification cataract extraction for different patient cooperation degree and eye condition. Methods Among 1752 eyes treated by small incision non-phacoemulsification cataract extraction, there were 1416 eyes (80.82%) received simple topical anesthesia, 314 eyes (17.92%) received topical anesthesia combined with subconjunctival anesthesia due to their incapacity for surgery caused by deafness and tension, and 22 eyes (1.26%) received peribulbar anesthesia due to glaucoma surgery, synechia, microcoria and lens subluxation. The patients’sight before and after operation, operation time, anesthetic effects, intraoperative and postoperative complications were recorded. Results In the first month after operation, there were 1528 eyes (87.21%) with the best corrected visual acuity≥0.5, and the average operation time was (9.25±4.11) min. There were 1372 eyes (78.31%) without obvious discomfort, and 380 eyes (21.69%) with swelling pain. There were 13 eyes (0.74%) with intraoperative complication of posterior capsule rupture and 4 eyes (0.23%) with suspensorium local fracture. There were 138 eyes (7.88%) with postoperative complication of corneal edema, 31 eyes (1.77%) with transient intraocular hypertension, and 2 eyes (0.11%) with entophthalmia. Conclusion The reasonable selection of different anaesthesia methods according to patients’condition in small incision non-phacoemulsification cataract extraction can promote the safety and success of operation.
