高龄白内障患者的全身疾病分析及围手术期处理  

Retrospective analysis of systemic diseases and perioperative treatment in 141 elderly cataract patients

作　　者：黄秀蓉[1] 张薇[2] 王红义[2] 余蓉[3] 程武波 

机构地区：[1]成都中医药大学附属医院眼科,中国四川省成都市610072 [2]成都中医药大学,中国四川省成都市610072 [3]成都中医药大学附属医院检验科,中国四川省成都市610072 [4]合川人民医院眼科,中国重庆市401520

出　　处：《国际眼科杂志》2011年第5期850-852,共3页International Eye Science

摘　　要：目的:回顾分析高龄白内障患者进行白内障手术的全身疾病及围手术期处理资料,以进一步提高此类患者的手术安全性。方法:分析2005-01/2008-12成都中医药大学附属医院眼科收治141例161眼年龄≥75岁患者施行白内障手术的相关临床资料。结果:术前因首次全身疾病评估暂未手术的共31例,占患者总数22.0%。经全身疾病治疗后有6例患者因全身疾病严重未行白内障手术而出院。术中对45例患者进行心电监护和持续低流量吸氧。术中13例患者出现血压升高;7例发生眼心反射。手术脱残率为91.9%,脱盲率为96.6%。结论:通过回顾性分析,为保证年龄相关性白内障伴全身疾病患者的手术安全,我们得出以下结论:(1)加强术前综合因素评估。(2)术前充分治疗全身病,严格掌握手术适应证。(3)术中心电监护和持续低流量吸氧,降低手术风险。(4)术中动作娴熟轻柔,避免眼心反射。(5)伴有全身疾病的白内障患者可适当放宽视力范围,及早手术。·AIM：To analyze the systemic diseases and perioperative treatment in elderly cataract patients,in order to improve the safety of the surgery.·METHODS：The clinical data of the 141 cases 161 eyes in cataract patients with age≥75 years old who underwent cataract surgery-related in Sichuan TCM hospital in the 4 years from January 2005 to December 2008 were observed.·RESULTS：Totally 31 cases with systemic disease patients temporarily gave up surgery after first assessment,accounting for 22.0% of the total number of patients.Six cases in 31 patients were discharged due to serious systemic diseases after treatment.ECG monitoring and continuous low flow oxygen were performed in 45 cases during operation.13 cases with high blood pressure.7 cases with OCR（Oculo-Cardiac reflex）.2 cases with cough.Postoperative corrected visual acuity：light perception to 0.05 in 5 eyes,accounting for 3.4%;0.05 to 0.3 in 7 eyes,accounting for 4.7%;≥0.3 in 137 eyes,accounting for 91.9%.·CONCLUSION：The patients with the systemic diseases should be strengthened to assess the preoperative factors before cataract surgery.The systemic diseases should be treated and strictly mastered operative indication and surgical contraindication.ECG monitoring and continuous low-flow oxygen are applied to minimize the risk of surgery.Gentle surgery action is taken to avoid the Oculo-Cardiac reflex.Cataract patients with systemic diseases are appropriate to relax the visual requirements,be operated as soon as possible.·

关 键 词：高龄 白内障 全身疾病 围手术期 

分 类 号：R776.1[医药卫生—眼科]