眼科手術後に発症した全身合併症

Systemic complications following ophthalmic surgery

　眼科手術を行った602名，744件について術後の全身合併症を検討した。

　対象は0歳から91歳で男272名，女330名，局所麻酔（以下局麻）621件，全身麻酔（以下全麻）123件，白内障が60％，網膜硝子体手術が12％，緑内障が2.6％であった。14名に術後全身合併症がみられた。譫妄が4名（1名肺炎を併発），呼吸器疾患が4名（喘息，肺炎，気管支炎，CO₂ナルコーシス），循環器疾患が2名（心筋梗塞，血栓性静脈炎），骨折と打撲が2名，その他3名（電解質失調，不明熱，脳出血）であった。高齢者や全身疾患をもつ60歳以上の患者は手術後，全身的に安全の保証はなく，いろいろの全身合併症が発生しうる。安易に日帰り手術はすべきではない。

We made a retrospective review on systemic complications following 744 eye surgeries in 602 hospitalized patients. The ages ranged from 0 to 91 years. Postoperative systemic complications developed in 14 cases, 2.3%. All the cases were aged 60 years or over except one. All the cases but one had manifested some systemic problems before surgery. The postoperative complications included delirium in 4 cases, respiratory diseases in 4, cardiovascular diseases in 2 and contusion or bone fracture in 2. Three of these 14 cases resulted in lethal outcome. The findings suggest that patients over 60 years with systemic illness need special attention to the general status following eye surgery.