老年眼科围手术前期血压安全范围探讨

The safe range discussion of early perioperative blood pressure in elderly ophthalmology

目的探讨老年眼科围手术前期血压控制的安全范围。方法临床病例系列研究。按入院次序选取2013年5-8月间深圳市眼科医院60岁以上住院手术患者333例，分为高血压合并糖尿病组，高血压无糖尿病组，无高血压病组共三组病人，分析其术前、术中血压变化。结果大部分患者收缩压与舒张压术中较术前有明显升高，差异有统计学意义（P〈0．05）；少部分患者（10．25％-18．87％）较前不升反降。收缩压升高均值明显高于舒张压升高均值，差异有统计学意义（P〈0．05）。无论术前、术中高血压两组（有、无糖尿病）与无高血压组收缩压之间相比差异有统计学意义（P〈0．05）；而舒张压之间相比差异无统计学意义（P〉0．05）；两组高血压患者相比差异无统计学意义（P〉0．05）。各组血压升高均值相比差异无统计学意义（P〉0．05）。结论眼科手术使患者血压显著升高，而对于收缩压的影响更明昆。术中高血压组收缩压明显高于无高血压组。高血压是否合并糖尿病对于血压升高无差异。老年眼科围手术前期血压控制在160／90mmHg以内较为安全适宜。

Objective To explore the safe ranges of the blood pressure in the elderly people on early ophthalmologic preoperative and perioperative operation by observing the blood pressure changes on eye surgery patients. Methods According to the hospital order selection, from May to August in 2013, 333 surgery patients over 60 years old were selected and divided into three groups, the first with hypertension and diabetes mellitus, the second only with hypertension, and the third without hypertension and diabetes. The blood pressure changes in the preoperative and intraoperative were analyzed. Results The majority of patients＇ systolic blood pressure and diastolic blood pressure in the perioperative operation increased significantly than in the preoperative and the difference was significant （P 〈0.05）; but some patients （10.25%-18.87%） blood pressure was lower. Systolic blood pressure increased significantly higher than diastolic blood pressure, and the difference was significant （P 〈0.05）. Both preoperative and intraoperative were significant difference （P 〈0.05） in systolic blood pressure between two hypertension groups and no hypertension group; but no significant difference （P 〉0.05） in diastolic blood pressure; there were no significant difference （P 〉0.05） in two hypertension groups. The mean increased in blood pressure had no significant difference （P 〉0.05） in each group. Conclusions Eye surgery makes the patients blood pressure increase significantly, and the influence of systolic blood pressure is obviously. Intraoperative the systolic blood pressure of hypertension group is obviously higher than that of without hypertension group. There is no difference for increase blood pressure whether the hypertension group has or no diabetes. Control the blood pressure of hypertension patients in the elderly people preoperative operation at 160/90mmHg is safe and suitable.