老年患者白内障超声乳化术入手术室血压异常事件的危险因素分析  

Clinical risk factors for abnormal elevation of blood pressure when entering theatre in elderly patients scheduled for phacoemulsification

作　　者：宋琳琳[1] 许幸[1] 

机构地区：[1]北京大学第一医院麻醉科,北京100034

出　　处：《中国实用眼科杂志》2010年第8期850-853,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 分析老年白内障超声乳化术患者入手术室血压异常升高事件的临床危险因素.方法 病例对照研究.择期行超声乳化术的350例白内障患者,年龄65~94岁,共行440例手术.按院内标准术前准备.术日入手术室后记录血压和心率.入室后收缩压≥180mmHg和（或）舒张压≥100mmHg者判定为血压异常升高事件,归为病例组,其余为对照组.对临床资料进行logistic回归分析入室后血压异常升高事件的危险因素.结果 体重指数≥30kg/m2和合并高血压病为入室后血压异常升高事件的独立危险因素（P分别为0.011和0.004）.术前焦虑程度、等候时间、手术次数、受教育程度等与入室后血压异常升高事件无关.合并高血压病者入室后血压异常升高事件的危险因素为术前重度焦虑和受教育程度低（P分别为0.016和0.023）,而受教育程度并不影响术前焦虑程度.结论 老年超声乳化术患者入室血压异常升高事件的危险因素为体重指数≥30kg/m2和合并高血压病.老年高血压病患者中受教育程度低和（或）术前重度焦虑者为入室血压异常升高事件的高危人群.老年患者行超声乳化术应控制入室前血压〈145/100mmHg.Objective To identify clinical risk factors for abnormal elevation of blood pressure immediately after entering theatre in elderly patients scheduled for phacoemulsification. Methods Case-control study design. Of 350 elective cataract patients （440 eyes）, aged 65-94, received phacoemulsifications. Standard preoperative management was performed for each patient. Blood pressure and heart rate were recorded immediately when entering theatre on operative day. Abnormal blood pressure elevation was defined as systolic pressure ≥180mmHg and/or diastolic pressure ≥100mmHg. Patients with abnormal blood pressure elevation were categorized into the case group, otherwise in the control group. Clinical factors were collected and analyzed with logistic regression. Results Body Weight Index （BMI） ≥30kg/m2 and hypertension of comorbidity were significantly related to abnormal blood pressure elevation when entering theatre （P =0.011 and 0.004 respectively） which was not associated with preoperative anxiety, waiting duration, operation times and educational level. For elderly patients with hypertension, preoperative anxiety and educational level were clinical risk factors for abnormal blood pressure elevation （P =0.016 and 0.023 respectively）, with no correlation between educational level and preoperative anxiety. Conclusions BMI ≥30kg/m2 and comorbid hypertension are clinical risk factors for abnormal blood pressure elevation immediately after entering theatre in elderly cataract patients. Medically hypertensive patients with low-degree educational level and/or preoperative severe anxiety are especially high risk. It is recommended that blood pressure right before entering theatre be controlled below 145/100mmHg for elderly patients scheduled for phacoemulsification.

关 键 词：超声乳化术 高血压 危险因素 

分 类 号：R779.66[医药卫生—眼科]