本文關(guān)鍵詞： 老年癡呆 智力低下 聾啞 白內(nèi)障超聲乳化手術(shù) 基礎(chǔ)麻醉　出處：《眼科新進(jìn)展》2015年03期 　論文類型：期刊論文

【摘要】：目的探討表面麻醉聯(lián)合基礎(chǔ)麻醉下超聲乳化術(shù)對(duì)配合度差(老年癡呆、智力低下、聾啞)的老年白內(nèi)障患者的手術(shù)安全性,并觀察術(shù)后并發(fā)癥、最佳矯正視力、血液流變學(xué)及淚膜穩(wěn)定性的變化情況。方法選取64例(87眼)老年癡呆、智力低下、聾啞老年白內(nèi)障患者,隨機(jī)分為A、B兩組。A組在表面麻醉下行白內(nèi)障超聲乳化+人工晶狀體植入術(shù);B組采用表面麻醉復(fù)合基礎(chǔ)麻醉下行白內(nèi)障超聲乳化+人工晶狀體植入術(shù)。術(shù)前、術(shù)中及術(shù)后2周觀察最佳矯正視力、術(shù)后并發(fā)癥、血液流變學(xué)及淚膜穩(wěn)定性情況。結(jié)果A組患者麻醉效果Ⅲ級(jí)22眼,B組患者Ⅲ級(jí)5眼,兩組差異有統(tǒng)計(jì)學(xué)意義(χ2=0.000,P0.05);兩組術(shù)前最佳矯正視力、心率、舒張壓和收縮壓、淚膜破裂時(shí)間(break up time,BUT)、基礎(chǔ)淚液分泌試驗(yàn)(Schirmer I test,SIT)差異均無統(tǒng)計(jì)學(xué)意義(均為P0.05),術(shù)中兩組患者心率、舒張壓和收縮壓相比差異均有統(tǒng)計(jì)學(xué)意義(t心率=9.158,t收縮壓=8.552,t舒張壓=7.259,均為P0.05);術(shù)后2周兩組患者最佳矯正視力相比差異有統(tǒng)計(jì)學(xué)意義(P0.05),而BUT及SIT差異均無統(tǒng)計(jì)學(xué)意義(均為P0.05)。B組手術(shù)時(shí)間(18.6±3.5)min明顯比A組(26.8±7.2)min短,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(t=6.524,P0.05);對(duì)比兩組術(shù)后并發(fā)癥,A組有12眼(27.27%),B組有5眼(11.63%),A組并發(fā)癥發(fā)生率明顯高于B組,兩組差異具有統(tǒng)計(jì)學(xué)意義(χ2=4.268,P0.05)。結(jié)論對(duì)配合度差的老年白內(nèi)障患者(如老年癡呆、智力低下、聾啞)實(shí)施超聲乳化手術(shù)時(shí),選用表面麻醉聯(lián)合基礎(chǔ)麻醉能在術(shù)中獲得更好的麻醉效果,提高患者的視覺質(zhì)量,值得臨床推廣應(yīng)用。
[Abstract]:Objective to investigate the surface anesthesia combined with basal anesthesia phacoemulsification on the matching degree of difference (senile dementia, mental retardation, deaf) operation safety of senile cataract patients, and postoperative complications, visual acuity, changes in blood rheology and stability of tear film. Methods 64 cases (87 eyes) of senile dementia the deaf, mental retardation, senile cataract patients were randomly divided into A group, B two group.A in the downlink of phacoemulsification and intraocular lens implantation with topical anesthesia; group B with surface anesthesia general anesthesia in phacoemulsification and intraocular lens implantation. Preoperative best corrected visual acuity were observed during and after the operation of 2 weeks, postoperative complications, blood rheology and tear film stability. Results A group of patients with anesthesia of 22 eyes, 5 eyes of patients in the B group, there was significant difference between two groups (2=0.000, P0.05); the two groups preoperative best corrected 姝ｈ鍔，

本文編號(hào)：1508122