本文選題：搏動(dòng)性眼血流 + 白內(nèi)障超聲乳化摘除術(shù)　； 參考：《汕頭大學(xué)》2010年碩士論文

【摘要】： 目的:探討白內(nèi)障患者在高灌注壓下行白內(nèi)障超聲乳化摘除術(shù)時(shí),其搏動(dòng)性眼血流的變化情況及相關(guān)影響因素。 方法:2009年10月至2009年12月在我院行白內(nèi)障超聲乳化摘除術(shù)的白內(nèi)障患者共77例納入本研究。根據(jù)患者的不同病情分成單純白內(nèi)障組(C組,23例)、白內(nèi)障合并青光眼組(G組,22例)、白內(nèi)障合并高血壓組(H組,19例)、白內(nèi)障合并糖尿病組(D組,13例)共4組。應(yīng)用搏動(dòng)性眼血流分析儀分別在手術(shù)前、手術(shù)中動(dòng)態(tài)測(cè)量眼內(nèi)搏動(dòng)性眼血流相關(guān)參數(shù),包括搏動(dòng)性眼血流(Pulsatile Ocular Blood Flow,POBF)、脈搏周期內(nèi)平均眼壓(Average-IOP)等。同時(shí)用心電監(jiān)護(hù)儀記錄相應(yīng)的血壓、心率。手術(shù)前測(cè)量時(shí)間為眼部消毒上開(kāi)瞼器后,手術(shù)中測(cè)量為超聲乳化時(shí)點(diǎn)及皮質(zhì)抽吸時(shí)點(diǎn)各測(cè)量1次。每次測(cè)量持續(xù)20秒,由儀器自動(dòng)選取波形最好的5個(gè)波作分析。超聲乳化時(shí)點(diǎn)灌注瓶高為120cm,負(fù)壓280mmHg,皮質(zhì)抽吸時(shí)點(diǎn)灌注瓶高為110cm,負(fù)壓450mmHg。 結(jié)果:與術(shù)前基線搏動(dòng)性眼血流相比,4個(gè)組在超聲乳化時(shí)點(diǎn)測(cè)得的搏動(dòng)性眼血流均有不同程度的下降;除G組外,余3個(gè)組在皮質(zhì)抽吸時(shí)點(diǎn)測(cè)得的搏動(dòng)性眼血流較超聲乳化時(shí)點(diǎn)進(jìn)一步下降,與術(shù)前基線值相比差異有統(tǒng)計(jì)學(xué)意義(C組:P0.001,H組:P0.001,D組:P=0.035)。4個(gè)組在3個(gè)時(shí)點(diǎn)測(cè)得的最高眼壓均出現(xiàn)在超聲乳化時(shí)點(diǎn),在該時(shí)點(diǎn)4個(gè)組所測(cè)得的平均眼壓介于54～60mmHg之間。與術(shù)前測(cè)得的基線眼壓相比,除G組在皮質(zhì)抽吸時(shí)點(diǎn)與術(shù)前無(wú)差異外(P=0.079),其余各組在術(shù)中兩個(gè)時(shí)點(diǎn)測(cè)得的眼壓均升高(P0.05)。單純白內(nèi)障患者的年齡和眼壓與POBF呈負(fù)相關(guān)關(guān)系,心率和收縮壓與POBF呈正相關(guān)關(guān)系。 結(jié)論:白內(nèi)障超聲乳化手術(shù)中,在高灌注壓的持續(xù)作用下,術(shù)中眼壓明顯升高,搏動(dòng)性眼血流則持續(xù)下降,提示持續(xù)高灌注壓下的白內(nèi)障超聲乳化手術(shù)可造成眼內(nèi)的血供減少。
[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.
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Sato E.;Feke G.T.;Menke M.N.;Wallace McMeel J.;喻平平;;老年性黃斑變性患者的視網(wǎng)膜血流動(dòng)力學(xué)[J];世界核心醫(yī)學(xué)期刊文摘.眼科學(xué)分冊(cè);2006年12期

2 張銘志,傅智伏,劉曉瑞,鄭策;原發(fā)性開(kāi)角型青光眼與正常人群搏動(dòng)性眼血流量比較研究[J];中華眼科雜志;2004年04期

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