超声乳化术中设定的眼压对视网膜中央动脉血流速度的影响

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研究目的：评估在白内障超声乳化术中设定的高眼压(IOP)对视网膜中央动脉和中央静脉血流状态的影响，并判断为应对术中急剧增加的IOP，眼部血流自动调节可能的代偿机制。

材料与方法：在这项前瞻性研究中包括23例不伴随眼部血管病变的白内障患者(15名女性和8名男性)，年龄在62到83岁之间。平均年龄为72.5±5.7岁。所有患者术中均通过超声扫描仪Logiq S8 (GE) 采用彩色多普勒模式和脉冲多普勒模式的彩色双侧扫描成像。测定了球后血管的血流量：即视网膜中央动脉，视网膜中央静脉以及记录的收缩期最大血流速度，舒张末期血流速度和阻力指数(RI)。该研究过程中通过Icare Pro眼压计测量IOP的水平，通过德尔格（Draeger Vista 120）患者监测仪监测患者的血压。在手术室中对眼部血流进行了三次检测：即术前检测；达到设定的IOP水平并封闭手术切口后立即检测；眼压恢复正常并重新封闭角膜隧道切口后的检测。

结果：在术中眼压维持在58.01±8.10 mm Hg水平时，发现视网膜中央动脉血流速度有临床显著降低(p<0.05)。在30.4%的病例中，没有记录到视网膜中央动脉舒张期血流速度。视网膜中央静脉血流速度无明显变化并且与IOP水平无关(p>0.05)。

结论：当人的IOP在 55- 60mm Hg水平时，应对术中急剧升高的IOP，眼部血流自动调节没有代偿机制，直至舒张期视网膜中央动脉血流完全停止，这可能是视网膜缺血的危险因素。

作者简介

Yuri Takhtaev

Academician I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: ytakhtaev@gmail.com

MD, Prof. of the Ophthalmology department

俄罗斯联邦, Saint Petersburg

Tatyana Kiseleva

Helmholtz National Medical Research Center of Eye Diseases

Email: tkiseleva05@gmail.com
ORCID iD: 0000-0002-9185-6407

MD, Head of Ultrasound Diagnostic Department

俄罗斯联邦, Moscow

Roman Shliakman

I.P. Pavlov First St Petersburg State Medical University of the Ministry of Healthcare of Russia

编辑信件的主要联系方式.
Email: romanshlyakman@gmail.com

Postgraduate Student, Ophthalmology department

俄罗斯联邦, Saint Petersburg

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