Are routine preoperative medical tests needed with cataract surgery?
Are routine preoperative medical tests needed with cataract surgery?
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DOI：
10.1590/s1020-49892001000700003
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发表时间：
2001-07-01
期刊：
影响因子：
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通讯作者：
Arieta, C E
中科院分区：
文献类型：
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作者：
Lira, R P;Nascimento, M A;Arieta, C E
目的：本研究的目的是调查是否常规的医疗测试白内障手术前减少并发症的发生率在围手术期adultes.METHODS：这项研究是在一个学术医疗中心在巴西，2000年2月10日和2001年1月10日之间进行。计划的白内障手术被随机分配到两组中的一组：1）在常规测试之前（“常规测试组”）或2）在常规医学测试之前（“选择性测试组”）。如果患者被分配到选择性测试组，则要求不进行术前测试，除非患者出现新的或恶化的医学问题，需要进行测试进行医学评价。在分配到常规测试组的患者的情况下，三个测试被要求：12导联心电图，全血细胞计数，血清glucose.RESULTS：样本的1,025例患者计划接受白内障手术，包括512分配到常规测试组和513分配到选择性测试组。两组手术取消且随后未重新安排的比例相似，每组均为2%。两组的医疗事件累积率相似，常规检测组为9.6%，选择性检测组为9.7%（P = 0.923）。医疗事件的类型也相似，在两个groups.Discussion：这项研究的结果表明，常规的医疗测试白内障手术前不减少围手术期并发症的发生率。结果还表明，除非患者病史或体格检查表明，否则不要求常规术前检查会更有效。
OBJECTIVE: The objective of this study was to investigate whether routine medical testing before cataract surgery reduces the rate of complications during the perioperative period in adults.METHODS: The study was carried out in an academic medical center in Brazil, between 10 February 2000 and 10 January 2001. The scheduled cataract operations were randomly assigned to one of two groups: 1) to be preceded by routine testing (the "routine-testing group") or 2) not to be preceded by routine medical testing (the "selective-testing group"). If the patient was assigned to the selective-testing group, it was requested that no preoperative testing be performed unless the patient presented with a new or worsening medical problem that would warrant medical evaluation with testing. In the case of patients assigned to the routine-testing group, three tests were requested: a 12-lead electrocardiogram, a complete blood count, and measurements of serum glucose.RESULTS: The sample of 1,025 patients scheduled to undergo cataract surgery was comprised of 512 assigned to the routine-testing group and of 513 assigned to the selective-testing group. The two groups had similar proportions of operations canceled and not subsequently rescheduled, 2% in each group. The cumulative rate of medical events was similar in the two groups, 9.6% in the routine-testing group and 9.7% in the selective-testing group (P = 0.923). The types of medical events were also similar in both groups.DISCUSSION: The results of this study suggest that routine medical testing before cataract surgery does not reduce the rate of complications during the perioperative period. The results also suggest it would be more efficient not to request routine preoperative tests unless indicated by patient history or physical examination.