国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (2): 109-114.doi: 10.3760/cma.j.cn115500-20240910-25205

• 综述 • 上一篇    下一篇

白内障手术患者的术前全身评估

周辉1   陈玲2  王济宾3   

  1. 1 无锡爱尔眼科医院内科,江苏无锡 214026; 2 无锡爱尔眼科医院护理部,江苏无锡 214026; 3 无锡爱尔眼科医院青白科,江苏无锡 214026
  • 收稿日期:2024-09-10 出版日期:2025-04-22 发布日期:2025-04-10
  • 通讯作者: 王济宾,Email:physician2003@163.com

Comprehensive preoperative evaluation of patients undergoing cataract extraction

Zhou Hui1, Chen Ling2, Wang Jibin3   

  1. 1 Department of Internal Medicine, Wuxi Aier Eye Hospital, Wuxi Jiangsu 214026, China; 2 Department of Nursing, Wuxi Aier Eye Hospital, Wuxi  Jiangsu 214026, China; 3 Department of Glaucoma and Cataract, Wuxi Aier Eye Hospital, Wuxi  Jiangsu 214026, China
  • Received:2024-09-10 Online:2025-04-22 Published:2025-04-10
  • Contact: Wang Jibin, Email: physician2003@163.com

摘要: 白内障摘除术详细的围手术期评估和管理策略对白内障手术至关重要。术前评估的目标是识别和降低威胁患者安全的潜在风险。通过对病史、眼部和其他相关检查的全面评估,临床医师可诊断出既往存在的疾病并且发现可能影响白内障手术结果的危险因素。全面的评估包括详细的手术计划和术中决策,可为选择合适的手术和麻醉方式提供关键信息。接受白内障手术的患者多为老年人,可能同时存在影响手术安全的全身性疾病(如高血压、糖尿病或心脏病等),评估和管理这些疾病,对于降低围手术期并发症至关重要。眼科医师、麻醉师和其他临床医师之间的多学科沟通协作是实施循证围手术期策略的关键。本文从与白内障手术相关的病史、全身检查、术前禁食、麻醉注意事项、对一些特定疾病(如高血压、心房颤动、慢性冠脉综合征、糖尿病、肺部疾病、终末期肾病、幽闭恐惧症、认知障碍)的考虑等几方面进行了综述。 (国际眼科纵览,2025, 49:109-114

关键词: 白内障摘除术, 术前评估

Abstract: A exhaustive perioperative evaluation and management strategy are overriding in cataract extraction. The primary goal of preoperative evaluation is to identify and reduce potential risks that threaten patient safety. Through comprehensive evaluation of medical history, eye examination, and other related examinations, clinical physicians can diagnose pre-existing diseases and identify risk factors that may affect the outcome of cataract surgery. A comprehensive evaluation should include detailed surgical plans and intraoperative decisions, assessing intraocular factors, which can provide key information for selecting appropriate surgical and anesthesia methods. Most of the patients receiving cataract surgery are elderly, and there may be systemic diseases (such as hypertension, diabetes or heart disease) that affect the safety of surgery at the same time. Evaluation and management of these diseases are essential to reduce perioperative complications. Multidisciplinary communication and collaboration between ophthalmologists, anesthesiologists, and other clinicians is key to executing evidence-based perioperative strategies.  This article reviewed the medical history related to cataract surgery, general examination, preoperative fasting, anesthesia precautions, and consideration of some specific diseases (such as hypertension, atrial fibrillation, chronic coronary syndrome, diabetes, lung disease, end-stage renal disease, claustrophobia syndrome, cognitive impairment).(Int Rev Ophthalmol, 2025, 49:  109-114)

Key words: cataract extraction, preoperative evaluation