局麻下斜视手术中末梢灌注指数的变化  

The change of tip perfusion index undergoing strabismus surgery with local anesthesia

作　　者：王媛[1] 刘春民[1] 宋桂婷[1] 韩冰[1] 赵东升[1] 贾惠莉[1] 邓宏伟[1] 

机构地区：[1]暨南大学附属深圳市眼科医院,深圳518040

出　　处：《中国斜视与小儿眼科杂志》2015年第1期25-26,9,共3页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的通过观察局部麻醉方式下,斜视手术中末梢灌注指数(TPI)变化,了解TPI变化趋势,推测TPI变化能否成为预测眼心反射(OCR)发生的指标。方法观察记录8位成年健康患者在局麻下斜视手术时术前和术中牵拉、放松14条眼外肌时的心率、TPI等的变化,判断是否发生OCR。结果 (1)TPI在牵拉至放松的过程中呈现先减少后增加的变化。(2)牵拉肌肉5s,放松牵拉10s,放松牵拉30s与手术麻醉完成后TPI的差值,三个时间段的变化有统计学意义(P<0.05)。(3)放松牵拉10s与麻醉完成时TPI差值变化,在以OCR有无的分组中,差异有统计学意义(P<0.05)。结论 (1)TPI的变化(△TPI)反映了牵拉肌肉至放松肌肉过程中,末梢循环血量先减少后增加的变化趋势。(2)在放松牵拉的过程中,△TPI有可能成为辨别是否发生OCR的指标。Objective To observe the change of tip perfusion index （TPI）undergoing strabismus surgery with local anesthesia. And to determine if TPI can be a predictor of oculocardiac reflex （OCR）.Methods 8 patients aged 24-48 years undergoing strabismus surgery with allocated anesthesia were selected randomly, and the changes of heart beat and TPI of them during the surgery were recorded. Result （1）The data of TPI decreased first and then increased during the surgery.（2） Part of the change of TPI（△TPI）were of statistical significance.（3） The change of TPI from anesthesia finishing to the muscle relaxation for 10 seconds was of statistical significance in group to the presence or absence of OCR. Conclusions （1） The change of peripheral blood circulation might decrease first and then increase.（2）△TPI might be a predictor of OCR.

关 键 词：斜视 眼心反射 眼外肌 麻醉 末梢灌注指数 

分 类 号：R779.6[医药卫生—眼科]