糖尿病白内障患者植入非球面人工晶状体的围手术期管理

Perioperative management of diabetic cataract patients undergoing aspherical intraocular lens implantation

目的:探讨糖尿病白内障患者植入非球面人工晶状体(intraocular lens,IOL)的围手术期管理策略。方法:选取2016年3月至2017年10月经内分泌科确诊为2型糖尿病且经眼科确诊为白内障的患者68例(89眼)为研究对象,采用超声乳化吸除术联合非球面IOL植入,围手术期对患者实行系统针对性管理。通过血糖监测和宣教,减少血糖波动;采用LogMAR视力记录方法分析手术前后视力,采用VF-12(visualfunction index-12,VF-12)量表进行视觉效果评价。结果:89眼均顺利完成手术;患者围手术期血糖较术前明显下降(P<0.001),且更趋于稳定;术后视力较术前显著提升(P<0.001);术前、术后VF-12量表评价得分分别为(22.04±6.31)分、(5.34±2.27)分,差异有统计学意义(P<0.001)。所有患者均痊愈出院。结论:系统针对性的围手术期管理可有效控制糖尿病白内障患者植入非球面IOL术围术期血糖,有利于术后视力恢复。

Objective：To explore the perioperative management strategies of diabetic cataract patients undergoing aspherical intraocular lens（IOL）implantation.Methods：From March 2016 to October 2017,68 cases（89 eyes）with diagnosis of type 2 diabetes mellitus and cataract were selected. The patients received combined treatment of phacoemulsification and aspherical IOL implantation,with systematic and individualized perioperative management.Levels of blood glucose were monitored and health education was conducted to reduce blood glucose fluctuation.Visual function was evaluated by LogMAR visual acuity and VF-12 index before and after the operation.Results：The surgery was successfully performed in all of the 89 eyes.The levels of perioperative blood glucose was significantly decreased and more stable compared with that before the operation（P〈0.001）.There was a significant increase in the visual acuity after the operation than that before the operation（P〈0.001）.There was a significant difference in VF-12 scores before and after the operation（22.04±6.31 vs 5.34±2.27,respectively,P〈0.001）.Conclusions：Systematic and individualized perioperative care is effective in the perioperative blood glucose control for diabetic cataract patients undergoing aspherical（IOL）implantation,and is beneficial to the postoperative visual function recovery.