依托咪酯靶控输注联合表面麻醉用于老年白内障患者超声乳化手术的临床研究

摘要

目的：：研究依托咪酯靶控输注联合表面麻醉用于老年白内障患者超声乳化手术的临床价值.方法：将在我院接受白内障超声乳化术＋人工晶体植入术的116例患者随机分为依托咪酯组(EP 组)和对照组,EP 组接受依托咪酯靶控输注联合表面麻醉,对照组仅接受表面麻醉,比较两组血流动力学特征、应激反应程度以及泪膜稳定性.结果：手术中,EP 组的 HR、SBP、DBP 与手术前比较,差异无统计学意义(P ＞0．05)；对照组的 HR、SBP、DBP 与手术前比较显著升高,且 EP 组的术中 HR、SBP、DBP 显著低于对照组,差异均具有统计学意义(P ＜0．05)；EP 组术中的血清 ACTH、COR、Glu、Ins、肾上腺素、去甲肾上腺素的含量均显著低于对照组(P ＜0．05),术后1周和2周时的 BUT、SIT 与对照组比较,差异无统计学意义(P ＞0．05).结论：依托咪酯靶控输注联合表面麻醉能够稳定老年白内障患者超声乳化手术的术中血流动力学、减轻应激反应,同时不会加重泪膜损伤.%Objective:To study the clinical value of target-controlled etomidate infusion combined with surface anesthe-sia for senile cataract patients with phacoemulsification.Methods:A total of 1 1 6 patients who received phacoemulsification +intraocular lens implantation in our hospital from were randomly divided into etomidate group (EP group)and control group, EP group received target-controlled etomidate infusion combined with surface anesthesia,control group received surface anes-thesia alone,and then hemodynamic features,stress degree and tear film stability of two groups were compared.Results:Dur-ing the operation,HR,SBP and DBP of EP groups were not significantly different from those before undergoing the operation (P >0.05).HR,SBP and DBP of control group were significantly higher those before operation (P <0.05),and intraoperative HR,SBP and DBP of EP group were significantly lower than those of control group (P <0.05);intraoperative serum ACTH, COR,Glu,Ins,epinephrine and norepinephrine levels of EP group were significantly lower than those of control group (P <0.05)while BUT and SIT 1 week and 2 weeks after operation were not significantly different from those of control group (P >0.05).Conclusion:Target-controlled etomidate infusion combined with surface anesthesia can stabilize the intraoperative hemo-dynamics and reduce stress response without exacerbating tear film damage in senile cataract patients with phacoemulsification.