手法小切口白内障手术球后麻醉发生球后出血的处理

目的观察手法小切口白内障摘出人工晶状体植入手术球后麻醉发生球后出血的处理方法及效果。方法对我院开展创建白内障无障碍市活动中，2007年5月至2008年5月所做的1196例（1200眼）手法小切口白内障手术球后麻醉发生球后出血的处理及效果，进行回顾性分析。结果1196例1200眼球后麻醉中，发生球后出血4例4眼，发生率0．33％。其中外伤性白内障1例1眼，老年性白内障3例3眼。球后麻醉拔针后发生出血2例2眼，手术进行中发生出血2例2眼。手术开始前发生出血者，经过压迫止血有效者5min后进行手术，无效者，暂停手术，1周后表麻下手术。手术进行中开始出血者，经压迫无效，中止手术。1周后表麻下继续完成手术。所有患者经如上处理后均取得良好的手术效果。结论球后麻醉发生球后出血者，根据发生时间、出血量的多少、眼球突出程度、眼压及眶压的高低，采取正确的处理方法，可取得良好的临床疗效。

Treatment of retrobulbar hemorrhage after retrobulbar anesthesia in manual small incision cataract surgery

Objective To observe the treatment of retrobulbar hemorrhage with retrobulbar anesthesia （RBA）in the surgery of manual small incision cataract extraction with IOL implantation. Methods Retrospectively analyzed the retrobulbar hemorrhage in 1196 cases（ 1200 eyes）of manual small incision cataract extraction with IOL implantation from May 2007 to May 2008 in the cataract sweeping activity organized at our hospital. Results There were 4 cases （4 eyes）of retrobulbar bleeding in the 1196 cases （1200 eyes ） , the rate was 0.33 %. Of the g cases, 1 case （ 1 eye） was traumatic cataract and 3 cases （3 ceyes） were senile cataract ;2 cases （ 2 eyes）occurred after withdrawal of needles and 2 cases（2 eyes） occured during the operation. When the bleeding occurred before operation,the surgery continued ＇after effective compression. Otherwise the surgery would be ceased for 1 week. When the bleeding occurred during operation,the surgery would be ceased for 1 week. After treatment, satisfying clinical efficacy was achieved. Conclusion According to the time of occurring, the amount of bleeding, the degree of exophthahnoses,and the pressure of the eye and the orbit, satisfying clinical efficacy is capable of being achieved by adopting the exact and prompt treatment of retrobulbar bleeding.