白内障手術後の全身合併症の防止対策

Prevention of systemic complications following cataract surgery

　1990年の当科白内障手術例で，50歳以上の297例に対し術後全身合併症防止対策を施行し，合併症の発症率と程度を，1988年に手術した未対策の354例と比較検討した。

　合併症防止対策としては第1に十分な術前後の補液，第2に高齢者の可及的早い時間帯（午前中）での手術，第3に厳重な術後管理がその内容である。術後合併症の発症率は未対策例の3.1％に対し0.7％と有意に減少し，75歳以上の高齢者では問題となる合併症を認めなかった。また，合併症の程度も比較的軽度な血圧低下と呼吸抑制のみであった。

　以上より，今回行った対策で術後全身合併症は十分に防止できると考えた。

We evaluated the incidence of systemic complica-tions immediately after cataract surgery in two groups of patients. The first group comprised 297 patients operated during the year 1990. The second group comprised 354 patients operated during 1988. The first group were cared with an anti-postope -complication program consisting of fluid transfu-sion over 500 ml, forenoon operation for elderly patients of over 75 years and intensive postoper-ative observations with ECG monitoring. The sec-ond did not receive such a specific care. The rate ofcomplications was 0.7 % in the first and 3.1 % in the second with a significant difference (p＜0.05). The systemic complications in the second group were severer than in the first. The former included one patient with cardiac arrest and two with car-diac infarction necessitating transfer to the inten-sive care unit. The latter consisted of two cases only, one with temporary hypotension and another with slight respiratory depression.

These result suggest the effectiveness of our anti -postope-complication program in preventing sys-temic complications after cataract surgery.