老年心血管病患者白内障围手术期安全性分析

Safety analysis of cataract surgery on senile patients with cardiovascular disease in the peri-operation period

目的:对老年心血管疾病患者行白内障围手术安全性分析。方法:对近2008-10/2010-09在我科住院拟行白内障手术的74例74眼老年心血管疾病患者的相关临床资料行回顾性分析。结果:老年心血管疾病患者4例4眼因术前评估发现手术禁忌证、无法耐受手术而未行白内障手术;其余70例70眼均在心电监护和持续低流量吸氧下安全行白内障手术,5例5眼白内障现代囊外摘出联合人工晶状体植入术,65例65眼白内障超声乳化摘除联合人工晶体植入术。有3例患者术前安装临时起搏器。术后随访1mo,术后最佳矫正视力<0.05者1例1眼(1.4%);0.05～者4例4眼(5.7%),≥0.3者65例65眼(92.9%)。术中均无严重全身和局部并发症发生,达到预期效果。结论:老年心血管疾病患者施行白内障摘除联合人工晶状体植入术应做好术前评估与术前准备,严格掌握手术适应证和手术禁忌证,术中应用心电监护提高手术安全性。

AIM：To evaluate safety and reliability of cataract surgery on the patients with cardiovascular disease in the peri-operation period METHODS：A retrospective study was performed in 74 senile cataract patients with cardiovascular disease which were treated by cataract surgery in the past 2 years.RESULTS：Four cases（4 eyes） did not have cataract surgery due to surgical contraindication;70 cases（70 eyes） with cardiovascular disease were treated with cataract surgery monitored by electrocardiography（ECG） and supplied by constant inhalation of low dose oxygen to minimize the surgical risk.5 cases（5 eyes） were treated by extracapsular cataract extraltion（ECCE）＋intraocular lens（IOL） implantation and 65 cases（65 eyes） were treated by phacoemulsification with IOL implantation.3 patients were installed temporary pacemakers before cataract surgery.After follow up for 1 month,65 cases（65 eyes） had a best corrected visual acuity（BCVA） equal to or more than 0.3（92.9%）;4 cases（4 eyes） had BCVA of 0.05 or less than 0.3（5.7%）;and 1 cases（1 eye） had BCVA less than 0.05（1.4%）.There were no severe complications during the operation.CONCLUSION：Senile cataract patients with cardiovascular disease must be evaluated before surgery.Surgical indications and contraindication must be controlled strictly.The electrocardiographic monitor is a necessary method to the senile cataract patients with cardiovascular disease in the operation.