【摘要】：目的：觀察喚醒麻醉聯(lián)合球結(jié)膜下注射利多卡因麻醉和單純使用球結(jié)膜下注射利多卡因麻醉在青少年水平共同性斜視及復(fù)雜非共同性斜視的手術(shù)病例中的鎮(zhèn)痛作用及對(duì)手術(shù)效果的影響。 方法：收集自2012年6月至2013年3月來我科行斜視矯正術(shù)的15-25歲青少年病例共91例。分為三組,其中70例單純水平共同性斜視隨機(jī)分為2組,21例復(fù)雜非共同性斜視分到第三組。采用的麻醉方法：組1和組3病人,采取喚醒麻醉聯(lián)合球結(jié)膜下注射1%利多卡因麻醉；組2病人單純予1%利多卡因球結(jié)膜下注射麻醉。三組病人均在術(shù)中予松解縫線觀察眼位,并對(duì)效果欠佳的病人行微調(diào)后縫合球結(jié)膜。術(shù)后1小時(shí)以內(nèi)對(duì)病人用改良數(shù)字評(píng)估法進(jìn)行痛覺評(píng)估,并在術(shù)后一周、一個(gè)月、三個(gè)月左右復(fù)查手術(shù)療效。 結(jié)果：將三組病例的痛覺評(píng)估行統(tǒng)計(jì)學(xué)分析,證明喚醒麻醉聯(lián)合局部麻醉鎮(zhèn)痛效果明顯優(yōu)于單純局部麻醉。將組1和組2術(shù)后斜視度復(fù)查做對(duì)比分析,發(fā)現(xiàn)兩種麻醉方法對(duì)術(shù)后療效影響無顯著差異。 結(jié)論：術(shù)中喚醒麻醉聯(lián)合球結(jié)膜下注射利多卡因麻醉可以有效的降低患者術(shù)中疼痛及不適。相比傳統(tǒng)的單純球結(jié)膜下注射利多卡因麻醉,鎮(zhèn)痛效果更好。同時(shí),由于2類麻醉都可以實(shí)現(xiàn)在術(shù)中觀察手術(shù)效果,并及時(shí)微調(diào),因此術(shù)后斜視均能達(dá)到有效矯正。
[Abstract]:Objective: To observe the analgesic effect and effect of lidocaine anesthesia combined with subconjunctival injection of lidocaine anesthesia combined with subconjunctival injection of lidocaine in the operation cases of adolescent horizontal concomitant strabismus and complex non concomitant strabismus.
Methods: a total of 91 cases of 15-25 year old adolescents with strabismus correction from June 2012 to March 2013 were divided into three groups, of which 70 cases were divided into 2 groups, 21 cases of complex non common strabismus were divided into third groups. The anesthesia methods were used in group 1 and 3 patients, with wake anaesthesia combined with conjunctival injection. 1% lidocaine anesthesia was shot; group 2 patients were given subconjunctival anesthesia with only 1% lidocaine. The three patients were treated with loosing suture and observed the eye position in the operation, and the patients who had poor effect were sutured with the conjunctiva. The patients were assessed with improved digital evaluation within 1 hours after the operation, and one week, one month, three after the operation. The effect of the operation was reviewed around the month.
Results: the pain evaluation of three groups of cases was statistically analyzed. It was proved that the analgesic effect of the wake anaesthesia combined with local anesthesia was obviously better than that of the simple local anaesthesia. Group 1 and group 2 were compared and analyzed after the reexamination of the strabismus, and there was no significant difference in the effect of the two anesthesia methods on the postoperative effect.
Conclusion: intraoperative anesthesia combined with lidocaine anesthesia combined with subconjunctival injection of lidocaine can effectively reduce the pain and discomfort in the operation. Compared with the traditional subconjunctival injection of lidocaine, the analgesic effect is better. At the same time, the effect of hand operation can be observed during the 2 types of anaesthesia, and it can be adjusted in time, so the postoperative strabismus is all Effective correction can be achieved.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R614

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