小切口非超声乳化白内障摘除术中麻醉方式的合理选择.docVIP

小切口非超声乳化白内障摘除术中麻醉方式的合理选择 　　【摘要】 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。 　　【关键词】 小切口；白内障摘除术；麻醉 　　【Abstract】 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 sma