老年高血压患者玻璃体切除术中脉压波动

The pulse pressure fluctuation in elderly patients with hypertension during pars plana vitrectomy surgeries

目的研究老年高血压患者玻璃体切除术中脉压(PP)波动的变化情况。方法选择2012年6月至2014年6月收治的60例需行玻璃体切除术的老年高血压患者,根据高血压病史和年龄将其随机分为老年高血压组(实验组,30例,30只眼)和老年正常血压组(对照组,30例,30只眼)。测量患者入院时(PP1)、玻璃体切除术术前结膜切口时(PP2)、切除玻璃体开始时(PP3)、玻璃体切除手术结束时(PP4)各时间点的脉压值,观察记录术前和术后所有患者视力及眼压变化,并确保患者的安全及手术顺利进行。结果所有患者均顺利成功完成手术,术中无特殊情况发生,术后所有患者视力均有提高(P<0.01),患者术后恢复情况良好,患者手术前后眼压均在正常范围,差异未见统计学意义(P>0.05)。结论玻璃体切除手术可以有效控制老年人的眼部疾病恶化,使老年患者的视力得到有效的改善,同时在手术切除过程中及术后,医护人员需要密切关注患者的各项生理指标,加强手术关注力度,从而确保手术的顺利进行及患者的术后康复。

Objective To study the pulse pressure（PP） fluctuation in elderly patients with hypertension during pars plana vitrectomy surgeries. Methods Selected （30 elderly patients needed pars plana vitrectomy surgeries from June 2012 to June 2014 according to the medical history of hypertension and age. They were randomly divided into two groups, including the elderly hypertension group （ experimental group, 30 cases, 30 eyes） and elderly normal blood pressure group （control group, 30 cases, 30 eyes）. The pulse pressure of patients at admission （PP1）, when the conjunctival incision vitrectomy preoperatively （PP2）, at the beginning of vitrectomy （PP3）, vitrectomy operation at the end （PP4） were all assessed, the preoperative and postoperative vision and intraocular pressure changes in all patients were observed and recorded, and ensure the patients＇ safety and operation smoothly. Results All patients successfully completed the operation smoothly, no special circumstance occur during operation, the visual of all the patients improved after operation （P〈0.01）, all of the patients had good postoperative recovery, the intraocular pressure were in the normal range before and after operation, there was no significant difference （ P 〉 0.05 ）. Conclusion Pars planavitrectomyoperation can effectively control eye disease deterioration in the elderly patients, so that elderly patients with vision improved, while patients in the process of operation excision and postoperative, health care workers need to pay close attention to the physiological index of patients, strengthen the operation concerned efforts, so as to ensure the smooth operation and the postoperative patients rehabilitation.