内眼手术中局部低温对血-眼屏障的保护作用  

Protecting effects of topical hypothermia to blood-ocular barriers in intraocular operation

作　　者：刘军[1] 李一壮[1] 陈晖[1] 印洪林[2] 

机构地区：[1]南京大学医学院附属鼓楼医院南京宁益眼科中心,江苏南京210008 [2]南京军区南京总医院病理科,江苏南京210002

出　　处：《医学研究生学报》2007年第7期712-714,719,共4页Journal of Medical Postgraduates

基　　金：南京市医学科技发展项目基金资助(批准号:YKK06090)

摘　　要：目的：研究在内眼手术中局部低温环境是否对血-眼屏障具有保护作用.方法：20只新西兰大白兔行双眼睫状体平部玻璃体切割术,术中左眼用低温（4～10 ℃）眼内灌注液为低温组,右眼用室温（25℃）眼内灌注液为室温组,每组各20只眼.术后24 h检查对比视网膜变化;玻璃体腔穿刺抽取眼内液送生化检测;取视网膜送透射电镜（TEM）检查.结果：低温组葡萄膜炎性反应普遍轻于室温组,屈光间质透明度总体优于室温组.眼内液总蛋白浓度室温组明显高于低温组,差异具有显著性意义（P＜0.01）.电镜下低温组视网膜节细胞超微结构改变轻微,而室温组则变性、损坏相对明显.结论：在实验动物眼后段手术中,局部低温环境对手术引起的创伤炎性反应具有抑制作用,对血-视网膜屏障有一定的保护作用.Objective： To investigate whether topical hypothermia circumstance has the protective effects to the blood-ocular barriers during intraocular operations. Methods ： Twenty New Zealand albino rabbits accepted vitrectomy in both eyes, useing hypothermal（4 -10℃ ） intraocular irrigating solution in left eye （hypothermal intraocular irrigating solution group）, and useing room temperature （25 ℃ ） intraocular irrigating solution in right eye （room temperature intraocular irrigating solution group）during the vitrectomy. Twenty-four hours after the operation, the retina of both eyes were checked; each eye accepted cavum vitreum perforation, and 0.5 ml of intraocular fluid were aspirsted for biochemical detection as well; as well as the retinas cut off for transmission electron microscopical （TEM） observa- tions. Results ： Inflammatory reaction of anterior ocular and the uvea in left eyes were generally slighter than the right eyes ; dioptric media clarity of left eyes were also better than that in left eyes ; average total protein concentration of the intraocular fluid was obviously lower than that in left eye（ P 〈0.01 ） ; Viewed with TEM, retinal ganglionic ceils of left eyes showed milder degenerative changes, ceils organ slightly swelled and maintained their basic shapes,but retinal ganglionic ceils of right eyes were highly swelled and where in various states of significant degeneration. Conclusion： In laboratory animal intraocular operation, topical hypothermia circumstance can reduce the inflammatory reaction of operation trauma, and this can propect blood-retina barrier.

关 键 词：局部低温 内眼手术 血-眼屏障 眼内灌注液 视网膜 玻璃体切割术 

分 类 号：R364.12[医药卫生—病理学]