腹部腹腔镜手术后眼结膜充血临床观察  

Clinical analysis of conjunctival congestion after celiac laparoscopic operation

作　　者：寇玉彬[1] 曹廷虎[1] 丁任[1] 

机构地区：[1]上海中医药大学附属曙光医院宝山分院外科,上海201900

出　　处：《中华腔镜外科杂志（电子版）》2013年第2期54-56,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的观察分析腹腔镜手术后眼结膜充血的可能发病原因、机制及防治措施。方法回顾性分析2004年5月至2012年5月腹腔镜气腹手术710例、免气腹腔镜212例的临床资料及术后眼结膜充血的发生情况。结果腹腔镜组手术后眼结膜充血发生28例,发生率约4.0%,免气腹组手术后眼结膜充血发生2例,发生率为0.5%。手术时间长短、气腹压力大小、是否使用气腹的发病率差异有统计学意义,术前合并高血压和/或糖尿病并发结膜炎的发病率差异无统计学意义。结论气腹是两组术后眼结膜充血发生率差别的主要原因。气腹压力大小可能是发病的独立危险因素。气腹内压过高导致毛细血管过度充盈受损可能是眼结膜充血的发生机制。控制腹内压是预防结膜充血发生的关键。合并高血压和/或糖尿病可能促进结膜充血的发生。Objective To analyze the incidence rate, reason, mechanisms, treatment and preventive methods on conjunctival congestion after celiac laparoscopic operation. Methods From May 2004 to May 2012, 710 patients were performed celiac laparoscopic operation and 212 patients laparotomy. The clinical data and the incidence rate of conjunctival congestion were retrospectively analyzed. Results Incidence rate of conjunctival congestion after celiac laparoscopic operation was 4.0% and the rate after laparotomy was 0.5% ,the diference was significant.It was significant among incidence rate of conjunctival congestion after celiac laparoscopic operation different persistent time and the pressure of operation. Conclusions Pneumoperitoneum is the capital reason of conjunctival congestion after celiac laparoscopic operation, and central venous pressure is so high to damage blood capillary, caused by higher intraabdominal pressure after pneumoperitoneum,is the mechanisms.To control intraabdominal pressure and operation time is the key to prevent conjunctival congestion.

关 键 词：腹腔镜手术 结膜充血 气腹 腹内压 

分 类 号：R779.6[医药卫生—眼科]