白内障超声乳化手术中高灌注压下搏动性眼血流的变化

发布时间：2018-05-15 15:25

本文选题：搏动性眼血流 + 白内障超声乳化摘除术　；参考：《汕头大学》2010年硕士论文

【摘要】： 目的:探讨白内障患者在高灌注压下行白内障超声乳化摘除术时,其搏动性眼血流的变化情况及相关影响因素。方法:2009年10月至2009年12月在我院行白内障超声乳化摘除术的白内障患者共77例纳入本研究。根据患者的不同病情分成单纯白内障组(C组,23例)、白内障合并青光眼组(G组,22例)、白内障合并高血压组(H组,19例)、白内障合并糖尿病组(D组,13例)共4组。应用搏动性眼血流分析仪分别在手术前、手术中动态测量眼内搏动性眼血流相关参数,包括搏动性眼血流(Pulsatile Ocular Blood Flow,POBF)、脉搏周期内平均眼压(Average-IOP)等。同时用心电监护仪记录相应的血压、心率。手术前测量时间为眼部消毒上开睑器后,手术中测量为超声乳化时点及皮质抽吸时点各测量1次。每次测量持续20秒,由仪器自动选取波形最好的5个波作分析。超声乳化时点灌注瓶高为120cm,负压280mmHg,皮质抽吸时点灌注瓶高为110cm,负压450mmHg。结果:与术前基线搏动性眼血流相比,4个组在超声乳化时点测得的搏动性眼血流均有不同程度的下降;除G组外,余3个组在皮质抽吸时点测得的搏动性眼血流较超声乳化时点进一步下降,与术前基线值相比差异有统计学意义(C组:P0.001,H组:P0.001,D组:P=0.035)。4个组在3个时点测得的最高眼压均出现在超声乳化时点,在该时点4个组所测得的平均眼压介于54～60mmHg之间。与术前测得的基线眼压相比,除G组在皮质抽吸时点与术前无差异外(P=0.079),其余各组在术中两个时点测得的眼压均升高(P0.05)。单纯白内障患者的年龄和眼压与POBF呈负相关关系,心率和收缩压与POBF呈正相关关系。结论:白内障超声乳化手术中,在高灌注压的持续作用下,术中眼压明显升高,搏动性眼血流则持续下降,提示持续高灌注压下的白内障超声乳化手术可造成眼内的血供减少。
[Abstract]:Objective: to investigate the changes and related factors of pulsatile ocular blood flow during phacoemulsification under high perfusion pressure in patients with cataract. Methods: from October 2009 to December 2009, 77 cataract patients underwent phacoemulsification in our hospital. The patients were divided into 4 groups: group C (23 cases), group G (22 cases), group H (19 cases) and group D (13 cases). The parameters related to intraocular pulsatile eye blood flow (Pulsatile Ocular Blood flow) and mean intraocular pressure (IOP) in pulse cycle were measured by pulsatile Ocular Blood flow analyzer before operation. The blood pressure and heart rate were recorded by ECG monitor. The time before operation was measured as the upper eyelid opener, the phacoemulsification time point and the cortical suction time point were measured once each. Each measurement lasts 20 seconds, the instrument automatically selects the best five waves for analysis. The height of the bottle was 120 cm, the negative pressure was 280 mm Hg, the height of the perfusion bottle was 110 cm at the time of cortical aspiration, and the negative pressure was 450 mm Hg at the time of phacoemulsification. Results: compared with baseline pulsatile ophthalmic blood flow before operation, the pulsatile eye blood flow measured at phacoemulsification time in all the four groups decreased in varying degrees. The pulsatile eye blood flow measured at the time of cortical aspiration in the other three groups was lower than that at the time of phacoemulsification. There was statistically significant difference between the baseline value of group C and that of group C: P0.001and group H: P0.001and group D: P0.001and group D: P0. 035.The highest IOP measured at three time points in four groups all appeared at the time of phacoemulsification, and the average IOP measured by four groups at that time was between 54~60mmHg and 54~60mmHg. Compared with baseline intraocular pressure (IOP) measured before operation, the intraocular pressure of group G was significantly higher than that of group G at two time points (P 0.05) except that there was no difference between group G and group G at the time of cortical aspiration. Age and intraocular pressure were negatively correlated with POBF, heart rate and systolic blood pressure were positively correlated with POBF. Conclusion: in phacoemulsification of cataract, intraocular pressure and pulsatile eye blood flow in cataract phacoemulsification were significantly increased under the continuous action of high perfusion pressure, suggesting that phacoemulsification under continuous high perfusion pressure could reduce intraocular blood supply.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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