眼筋膜囊内麻醉在小切口非超声乳化白内障摘除术中临床观察.docVIP

眼筋膜囊内麻醉在小切口非超声乳化白内障摘除术中临床观察 　【摘要】 　　目的：探讨眼筋膜囊内麻醉在普通及特殊情况的小切口非超声乳化白内障摘除、人工晶状体植入术中的安全性及有效性。方法：对98例（118眼）白内障患者行小切口非超声乳化白内障囊外摘除、人工晶状体植入术，观察其麻醉效果及对血压、呼吸、心率及心电图的影响。结果：所有患者在眼筋膜囊内麻醉下均能很好的配合手术顺利完成，无1例改用其它麻醉方法。平均手术时间为24.35min。随机选择30例术中行心电监护，表明眼筋膜囊内麻醉对血压、呼吸、心率无明显影响，并且术毕生命体征均恢复正常。结论：眼筋膜囊内麻醉下小切口非超声乳化白内障囊外摘除、人工晶状体植入术是安全有效的，尤其对于特殊情况的白内障手术，其相比表面麻醉和球后或球周麻醉具有一定的优越性。 【关键词】 眼筋膜囊内麻醉　小切口　非超声乳化白内障摘除 　　Clinical observation of Subtenon’s anesthesia in small incision non-phacoemulsification cataract extraction and IOL implantation AbstractAIM: To investigate the safety and efficacy of subtenon’s anesthesia in small incision non-phacoemulsification cataract extraction and (intraocular lens) IOL implantation.METHODS: Under subtenon’s anesthesia small incision non-phacoemulsification cataract extraction and IOL implantation were performed in 98 patients (118 eyes), and the efficacy of Subtenon’s anesthesia the on blood pressure, respiration, heart rate and the changes of electrocardiogram were observed. RESULTS: All operations were smoothly finished under Subtenon’s anesthesia without any additional retrobulbar or peribulbar anesthesia, and all the patients co-operated well with the operators during the operations. The mean duration of the operation was 24.35 minutes (15-50 minutes). There was not obvious change in electrocardiographic monitoring.CONCLUSION: Small incision non-phacoemulsification cataract extraction and IOL implantation under subtenon’s anesthesia is safe and effective, especially in some pecial cataracts. · KEYWORDS: subtenon’s anesthesia; small incision; non-phacoemulsification cataract extraction 　　0 引言 小切口非超声乳化白内障摘除、人工晶状体植入术由于术后视力恢复快，所需费用低廉，疗效可靠，已有较多报道[1-4]。表面麻醉组织损伤小，但要求术者有丰富的白内障手术经验。传统的球周或球后麻醉可以维持较长的麻醉时间，但不可避免出现一些并发症。因此，我们对98例患者(118眼)进行了眼球筋膜囊内麻醉下小切口非超声乳化白内障摘除、人工晶状体植入术，效果满意，现报告如下。 1对象和方法 1.1对象 收集行小切口非超声乳化白内障摘除、人工晶状体植入术98例（118眼），手术采用眼球筋膜囊内麻醉。其中男48例，女50例，患者年龄为18～96岁，118例手术中98例为常规白内障手术，20例为特殊情况的白内障（包括葡萄膜炎并发的白内障10例、抗青光眼术后白内障7例以及合并晶状体源性青光眼的白内障3例）摘除、人工晶状体植入术。患者收缩压或用药后收缩压为11