窦性心动过缓患者接受白内障超声乳化手术的优越性  

The Heart Rate Changes in the Patients with Sinus Bradycardia while Undergoing Cataract Extraction with Phacoemulsification

作　　者：杨延灵[1] 方秋云[2] 

机构地区：[1]广州医学院第二附属医院心电图室,广州510260 [2]广州医学院第二附属医院眼科,广州510260

出　　处：《广州医学院学报》2002年第3期37-39,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的 :评估窦性心动过缓患者对球后阻滞麻醉白内障超声乳化手术所致眼心反射的承受能力。方法 :5 9岁以上的窦性心动过缓患者 6 1例 ,入院时常规心电图检查以记录术前心率 ,心电监护球后阻滞麻醉白内障超声乳化摘除加人工晶体植入手术中的心率变化 ,记录球后麻醉注射时、按压眼球时和人工晶体植入时的最低平均心率(分别取心电监护仪所显示的 10次最低心率数值的平均值 ) ,心率减慢或加快的数值等于或大于术前心率的 10 %就记为心率加快或减慢。结果 :与术前相比 ,球后麻醉注射时心率加快 (P <0 .0 1) ;按压眼球时心率渐回复 ,1例的心率急剧下降 ,停止按压眼球后即回复 ;手术操作过程中心率平稳于术前状态。结论 :窦性心动过缓患者对白内障超声乳化手术所致眼心反射有较好的承受能力 。Objective:To evaluate the tolerance of the patients with sinus bradycardia to the oculocardiac reflex caused by cataract extraction with phacoemulsification and intraocular lens implantation under retrobulbar anesthesia. Methods: Sixty one patients with sinus bradycardia had been studied. Their heart rates were recorded by electrocardiography on hospitalization as their original heart rates. Their heart rate changes were showed by electrocardiographic monitoring during cataract extraction with phacoemulsification and intraocular lens implantation under retrobulbar anesthesia. The three lowest average heart rates were recorded to study. They were calculated from the 10 lowest heart rate value showed by electrocardiographic monitoring respectively during retrobulbar narcotic injection,eyeball oppressing,and lens implantation A reduction or ≥10% increment upon the original heart rates were recorded as Lowered or accelerated HR. Results: Compared with their original heart rates test on hospitalization,the heart rates increased significantly at the time of retrobulbar narcotic injection ( P <0.01),and decreased gradually during eyeball oppressing with only one patient's heart rate lowering dramatically to 28 beat per minute and rising rapidly after stopping eyeball oppressing.The heat rates were steady at the level of their original ones during operation. Conclusion: The patients with sinus bradycardia show good tolerance to the oculocardiac reflex caused by cataract extraction with phacoemulsification and intraocular lens implantation under retrobulbar anesthesia. But the heart rate changes must be carefully observed at the time of eyeball oppressing.

关 键 词：窦性心动过缓 白内障 眼心反射 球后麻醉 

分 类 号：R779.66[医药卫生—眼科]