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为评估采用表面麻醉进行白内障超声乳化术的可靠性、有效性及安全性 ,对 173例白内障患者经表面麻醉进行白内障超声乳化术。随机选取同期手术的另外 173例患者采用标准的球后麻醉做为对照组。比较两组患者不同麻醉方法的并发症 ,以及两组患者术中的配合程度及疼痛感。结果 :球后麻醉组中 ,结膜水肿、结膜下出血及眼睑出血的发生率显著高于表面麻醉组 (P<0 .0 0 1) ,另有 2例发生球后出血。表面麻醉组中未见类似并发症。表面麻醉组中 16 0例 (92 .5 % )均能较好地配合手术 ,无需追加球周麻醉。仅 1例无法正常合作 ,而追加球周麻醉 ,与球后组相比无显著性差异 (P>0 .0 5 )。表面麻醉组中除 3例术中因瞳孔小 ,虹膜被意外触及时感轻度疼痛外 ,其余 170例 (98.3% )患者均无明显疼痛感。结论 :表面麻醉对于白内障超声乳化术是一种安全、有效 ,并发症少的麻醉方法。适当的术前病例选择及患者的心理准备是必要的
To evaluate the reliability, efficacy, and safety of topical anesthesia for cataract phacoemulsification, 173 cataract patients undergoing topical anesthesia were phacoemulsified. Another 173 patients randomly selected for concurrent surgery underwent standard retrobulbar anesthesia as a control. The complications of different anesthesia methods in two groups were compared, and the degree of cooperation and pain in the two groups were compared. RESULTS: The incidence of conjunctival edema, subconjunctival hemorrhage and blepharitis in the posterior capsule group was significantly higher than that in the topical anesthesia group (P <0. 001) and in 2 patients with posterior bulbar hemorrhage. No similar complications were seen in the topical anesthesia group. In the topical anesthesia group, 160 cases (92.5%) were able to cooperate well without additional periarthritis. Only 1 case failed to cooperate normally, while the extra-ball anesthesia had no significant difference compared with the posterior ball group (P> 0.05). In the topical anesthesia group, the remaining 170 patients (98.3%) had no obvious pain sensation except for the three patients with small pupil during surgery and mild pain when the iris was accidentally touched. Conclusion: Surface anesthesia is a safe, effective and less-complication method for phacoemulsification. Appropriate preoperative case selection and patient psychology is necessary