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目的探讨老年全身病患者白内障手术的治疗。方法回顾性分析近6年我科对198例(206眼)老年全身疾病患者施行白内障手术的相关临床资料。结果198例(226眼)老年全身病患者安全施行白内障超声乳化或小切口白内障摘除联合人工晶状体植入术。术后随访1~24个月,术后最佳矫正视力:光感至<0.05者6例(8眼),占3.03%;0.05~0.3者26例(30眼),占13.13%;≥0.3者166例(188眼),占83.84%。手术脱残率为83.19%,脱盲率为96.46%。手术中均无严重全身和局部并发症发生,达到预期效果。结论对老年全身病患者的围手术期处理,应严格掌握手术适应症和手术禁忌症;对于IV级及以上的晶状体核采用非超声乳化小切口白内障摘除联合人工晶状体植入术较白内障超声乳化联合人工晶状体植入术为佳;药物的应用应个体化;特殊类型患者手术中采用心电监护和持续低流量吸氧,使手术风险降至最低。
Objective To investigate the treatment of cataract surgery in elderly patients with systemic diseases. Methods Retrospectively analyzed the clinical data of 198 cases (206 eyes) of elderly patients with systemic diseases who underwent cataract surgery in recent 6 years. Results 198 cases (226 eyes) of elderly patients with systemic diseases were safely phacoemulsified or small incision cataract extraction combined with intraocular lens implantation. Postoperative follow-up of 1 to 24 months, best corrected visual acuity after surgery: light perception to <0.05 in 6 cases (8 eyes), accounting for 3.03%; 0.05 to 0.3 in 26 cases (30 eyes), accounting for 13.13%; 166 cases (188 eyes), accounting for 83.84%. Surgical incontinence rate was 83.19%, the blindness rate was 96.46%. No serious systemic and local complications occurred during the operation, achieving the expected results. Conclusions Perioperative management of elderly patients with systemic diseases should be strictly controlled surgical indications and surgical contraindications; for IV and above phacoemulsification cataract extraction combined with intraocular lens implantation using non-phacoemulsification cataract extraction combined with phacoemulsification Intraocular lens implantation is preferred; the application of the drug should be individualized; the use of ECG and continuous low-flow oxygenation during surgery in a particular type of patient minimizes the risk of surgery.