应用共焦扫描激光多普勒视网膜血流分析仪检测视网膜脱离术后患者眼底血流参数  

Application of confocal scanning laser Doppler retinal flowmetry in the measurement of fundus blood flow parameters after retinal detachment surgery

作　　者：陈松[1] 韩梅[1] 张珑俐[1] 张树立[1] 王兰惠[1] 魏景文[1] 

机构地区：[1]天津市眼科医院,300070

出　　处：《中华眼科杂志》2002年第3期140-143,共4页Chinese Journal of Ophthalmology

摘　　要：目的　探讨视网膜脱离 (retinaldetachment,RD)手术对患者视网膜和视乳头血流的影响。方法　应用共焦扫描激光多普勒视网膜血流分析仪 (heidelbergretinaflowmeter,HRF)检测 6 2例 (6 2只眼 )单眼孔源性RD术后患者的视网膜和视乳头血流参数。其中 34只眼采用玻璃体视网膜(vitreoretinal,VR)手术 ,2 8只眼采用常规巩膜扣带 (scleralbucking ,SB)术 ,手术方式包括巩膜环扎术、巩膜外冷冻术、晶状体或玻璃体切除术、眼内激光光凝术 ,术中应用全氟萘烷液体、长效气体及硅油填充等。结果　RD组与对照组比较 ,眼底血流量、血流速及红细胞移动速率均降低 ,颞侧视乳头盘沿及鼻侧视乳头盘沿的红细胞移动速率差异均有显著意义 (P <0 0 5 ) ;视乳头大血管血流量、血流速及红细胞移动速率 ,颞侧、鼻侧视乳头盘沿的血流量及血流速 ,颞侧、鼻侧视乳头旁视网膜血流量相比较 ,差异均有非常显著意义 (P <0 0 1)。VR术组与SB术组比较 ,其血流量、血流速及红细胞移动速率均明显降低 ;颞侧、鼻侧视乳头盘沿 ,鼻侧视乳头旁视网膜的红细胞移动速率 ,颞侧视乳头旁视网膜的血流速比较 ,差异均有显著意义 (P <0 0 5 )。硅油填充组与未填充组比较 ,其眼底血流量、血流速及红细胞移动速率均降低 ;Objective To discuss the influence of retinal detachment (RD) surgery on the blood flow of retina and optic nerve head. Methods Heidelberg Retina Flowmeter (HRF) was used to measure the blood flow of retina and optic nerve head in 62 eyes of 62 patients with postoperative rhegmatogenous RD surgery, including 34 eyes having undertaken vitreoretinal (VR) surgery and 28 eyes, scleral buckling (SB) surgery. Operative methods included scleral encircling procedure, cryotherapy, lensectomy, vitrectomy, perfluorodeclin liquid application, endolaser and C 2F 6 gas or silicone oil tamponade. Results The blood flow volume (VOL), blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of fundus in the postoperative RD eyes were reduced in the comparison with those of the fellow control eyes. The VEL of temporal and nasal papillary disk rim had significant differences ( P <0.05). The VOL, FLW and VEL of the papillary vessel, VOL and FLW of temporal and nasal papillary disk rim, VOL of temporal and nasal juxtapapillary retina in the operative eyes were lower than those of the fellow eyes ( P <0.01). In the comparison between the eyes having undertaken VR surgery and the eyes undertaken SB surgery, the VOL, FLW and VEL of VR surgery were reduced more than those of SB surgery. The VEL of temporal and nasal papillary disk rim and nasal juxtapapillary retina and FLW of temporal juxtapapillary retina had significant differences ( P <0.05). VOL, FLW and VEL of silicone oil tamponade eyes were reduced more than those in the operative eyes without silicone oil tamponade. VOL of nasal papillary disk rim and juxtapapillary retina had significant differences ( P <0.05). VOL and VEL of temporal papillary disk rim, VOL of temporal juxtapapillary retina had very significant differences ( P <0.01). Conclusions VR surgery and SB surgery of RD influence papillary and retinal VOL, FLW, VEL. The influence of VR surgery on the fundus blood flow is more significant than that of SB surgery. The silicone oil tamponade al

关 键 词：视网膜脱离 玻璃体切除术 巩膜扣带术 激光多普勒流量测定 视网膜 血液动力学 

分 类 号：R770.43[医药卫生—眼科]