中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
Chinese Journal of Practical Ophthalmology
2015年
10期
1150-1153
,共4页
经巩膜激光睫状体光凝术%难治性青光眼%围术期管理
經鞏膜激光睫狀體光凝術%難治性青光眼%圍術期管理
경공막격광첩상체광응술%난치성청광안%위술기관리
Transscleral cyclophotocoagulation%Refractory glaucoma%Perioperative management
目的 探讨经巩膜二极管激光睫状体光凝术的围术期管理要点.方法 回顾性分析2009年5月至2012年2月在天津市眼科医院经巩膜激光睫状体光凝术治疗的青光眼患者182例,术前行体格健康状况(ASA)分级与评估,术前全身及局部用药调控眼压.拟球后阻滞和全身麻醉.视觉模拟评分法对术前、术后疼痛评分.结果 术前重要脏器功能评估:心电图显示异常30.8％,(56/182),高血压33.5％ (61/182),肾功能异常7.1％ (13/182),糖尿病20.1％ (38/182),血钾低0.01％ (2/182),肺心病2.7％ (5/182),肥胖14.3％ (26/182),高龄(年龄＞75岁)31.3％ (57/182).术后1天与1个月眼压与治疗前相比差异均有统计学意义(P =0.00,P=0.00).行x2列表检验术前与术后1、24 h疼痛,差异有统计学意义,(P =0.00,P=0.00).结论 经巩膜二极管激光睫状体光凝术是有效的治疗难治性青光眼的方法,患者全身合并症多,术前应进行全身状况评估与眼压调控.球后阻滞与全身麻醉并配合术后镇痛可保证围术期安全.
目的 探討經鞏膜二極管激光睫狀體光凝術的圍術期管理要點.方法 迴顧性分析2009年5月至2012年2月在天津市眼科醫院經鞏膜激光睫狀體光凝術治療的青光眼患者182例,術前行體格健康狀況(ASA)分級與評估,術前全身及跼部用藥調控眼壓.擬毬後阻滯和全身痳醉.視覺模擬評分法對術前、術後疼痛評分.結果 術前重要髒器功能評估:心電圖顯示異常30.8％,(56/182),高血壓33.5％ (61/182),腎功能異常7.1％ (13/182),糖尿病20.1％ (38/182),血鉀低0.01％ (2/182),肺心病2.7％ (5/182),肥胖14.3％ (26/182),高齡(年齡＞75歲)31.3％ (57/182).術後1天與1箇月眼壓與治療前相比差異均有統計學意義(P =0.00,P=0.00).行x2列錶檢驗術前與術後1、24 h疼痛,差異有統計學意義,(P =0.00,P=0.00).結論 經鞏膜二極管激光睫狀體光凝術是有效的治療難治性青光眼的方法,患者全身閤併癥多,術前應進行全身狀況評估與眼壓調控.毬後阻滯與全身痳醉併配閤術後鎮痛可保證圍術期安全.
목적 탐토경공막이겁관격광첩상체광응술적위술기관리요점.방법 회고성분석2009년5월지2012년2월재천진시안과의원경공막격광첩상체광응술치료적청광안환자182례,술전행체격건강상황(ASA)분급여평고,술전전신급국부용약조공안압.의구후조체화전신마취.시각모의평분법대술전、술후동통평분.결과 술전중요장기공능평고:심전도현시이상30.8％,(56/182),고혈압33.5％ (61/182),신공능이상7.1％ (13/182),당뇨병20.1％ (38/182),혈갑저0.01％ (2/182),폐심병2.7％ (5/182),비반14.3％ (26/182),고령(년령＞75세)31.3％ (57/182).술후1천여1개월안압여치료전상비차이균유통계학의의(P =0.00,P=0.00).행x2렬표검험술전여술후1、24 h동통,차이유통계학의의,(P =0.00,P=0.00).결론 경공막이겁관격광첩상체광응술시유효적치료난치성청광안적방법,환자전신합병증다,술전응진행전신상황평고여안압조공.구후조체여전신마취병배합술후진통가보증위술기안전.
Objective To discuss the proper preoperative period management of transscleral cyclophotocoagulation in the treatment of refractory glaucoma.Methods Retrospectively analyzed the 182 eyes of 182 patients who accepted transscleral cyclophotocoagulation in Tianjin eye hospital from May 2009 to February 2012.ASA classification was used, local anesthesia combined with general anesthesia.Visual analogue scale was used to get the pain score before and after coagulation.Results Preoperative systemic functional assessment: 30.8％ (56/182) had ECG abnormal, 33.5％ (61/ 182) had hypertension, 7.1％ (13/182) had abnormal renal function, 20.1％ (38/182) had diabetes, others: low potassium 2 cases, pulmonary heart disease 5 cases, obesity 26 cases, 31.3％ (57/182) were older than 75 years old.Postoperative 1 day, 1 month intraocular pressure difference compared with before treatment were statistically significant (F =1,43, P =0.00;F =2.24, P =0.00.) Pearson R*C test, postoperative pain score within 1 hour and 24 hours had significantly difference compared with preoperative pain score (P =0.00, P =0.00).Conclusions Transscleral cyclophotocoagulation is an effective treatment to refractory glaucoma, Patients have more systemic complications.Local anesthesia combined with general anesthesia is effective to control postoperative pain.Reasonable perioperative management is the effective guarantee for the safe operation.
