布林佐胺联合肩垫对妇科腹腔镜手术中眼内压增高的干预作用研究  

Research on the intervention effect of brinzolamide combined with shoulder pads on hyper-intraocular pressure in gynecological laparoscopic operation

作　　者：左艳霞[1] 秦寿泽[1] 周杰 肖红岩[1] 吴淑娟 张凤敏[1] 

机构地区：[1]河北省石家庄市第三医院,河北石家庄050011 [2]河北省定州市第二医院,河北定州073000 [3]河北省石家庄市妇幼保健院,河北石家庄050051

出　　处：《现代中西医结合杂志》2016年第24期2635-2638,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省医学科学研究重点课题(20150882)

摘　　要：目的探讨布林佐胺滴眼液滴眼联合楔形10°-15°肩垫垫肩对妇科腹腔镜手术中眼内压增高的调节作用。方法选取ASA I或Ⅱ级子宫肌瘤行腹腔镜子宫切除术患者60例,随机分为试验组和对照组各30例。2组均采用头低脚高20°-30°体位,摆好体位后,对照组双眼滴生理盐水,试验组给予楔形10°-15°肩垫垫于头肩下,同时双眼滴布林佐胺滴眼液。监测2组全麻后5 min（t0）、T位气腹且楔形10°-15°肩垫垫肩联合布林佐胺滴眼液滴眼或生理盐水滴眼后30 min（t1）、60 min（t2）、120 min（t3）、气腹结束且平卧位后30 min（t4）的眼内压（IOP）、平均动脉压（MAP）、心率（HR）、中心静脉压（CVP）、呼气末二氧化碳分压[pET（CO2）]和气道压力（paw）的变化。结果 2组t1-t3时点IOP和MAP、HR、CVP、pET（CO2）、paw均明显高于t0和t4时点（P均〈0.05）,且试验组t1-t3时点IOP和CVP均明显低于对照组（P均〈0.05）;2组间t0-t4时点MAP、HR、pET（CO2）和paw比较差异均无统计学意义（P均〉0.05）。结论妇科腹腔镜术中应用布林佐胺滴眼液滴眼联合肩垫垫肩,可有效降低IOP和CVP,预防视神经损伤。Objective It is to investigate the effects of brinzolamide combined with shoulder pads on the intraocular pressure（ IOP） during gynecological laparoscopic surgery. Methods 60 cases of ASA Ⅰ or Ⅱ of patients with uterine fibroids who planned to perform laparoscopic hysterectomy were selected and divided into the experimental group and the control group with30 cases in each groups. All the patients had 20° to 30° trendelenburg after pneumoperitoneum. The patients were given brinzolamide eye drops combined with 10° to 15° shoulder pads in the experimental group,and only physiological saline in the control group. The changes of intraocular pressure（ IOP）,heart rate（ HR）,mean arterial pressure（ MAP）,central venous pressure（ CVP）,end-tidal carbon dioxide partial pressure [pET（ CO2） ],airway pressure（ paw） were measured in the both groups at 5 min after anesthesia（ t0）,30 min（ t1）,60 min（ t2）,120 min（ t3） and 30 min（ t4） and compared. Results MAP,HR,CVP,pET（ CO2）,paw and IOP of the both groups at t1,t2 and t3were significantly higher than at t0,t4（ all P〈0. 05）,and IOP,CVP of the experimental group at t1,t2 and t3were significantly lower than that of the control group（ all P〈0. 05）. There was no significant difference in MAP,HR,pET（ CO2） and pawat t0,t2,t3 and t4between the both groups（ all P〈0. 05）. Conclusion Brinzolamide combined with shoulder pads can reduce the intraocular pressure and central venous pressure,and effectively prevent the intraocular hypertension during gynecological laparoscopic surgery.

关 键 词：妇科腹腔镜 眼内压 布林佐胺滴眼液 肩垫 

分 类 号：R614[医药卫生—麻醉学]