布林佐胺滴眼液干预对妇科腹腔镜手术眼内压的影响  

The Brinzolamide treatment on intraocular pressure in gynecological laparoscopic operation

作　　者：左艳霞[1] 秦寿泽[1] 肖红岩[2] 周杰 吴淑娟 张凤敏[1] 

机构地区：[1]河北省石家庄市第三医院麻醉科,河北石家庄050011 [2]河北省石家庄市第三医院科教科,河北石家庄050011 [3]河北省定州市第二医院骨科,河北定州073000 [4]河北省石家庄市妇幼保健院产科,河北石家庄050051

出　　处：《河北医科大学学报》2016年第7期814-817,共4页Journal of Hebei Medical University

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对妇科腹腔镜手术中眼内压增高的调节作用。方法选取美国麻醉师协会分级Ⅰ或Ⅱ级妇科患有子宫肌瘤行腹腔镜子宫切除术患者60例作为研究对象,采用随机数字表法分为2组:布林佐胺组(n=30)和对照组(n=30)。监测2组全身麻醉后5 min(T0),T位气腹且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),气腹结束后30 min(T4)的眼内压(intraocular pressure,IOP),同时监测平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,PETCO2)和气道压力(airway pressure,Paw)的变化。结果 2组IOP均升高,但布林佐胺组较对照组升高幅度小,2组组间、时点间以及组间·时点间交互作用差异均有统计学意义(P<0.05);随着时间的延长,2组MAP、HR和PETCO2、Paw均逐渐升高,其时点间差异有统计学意义(P<0.05)。结论妇科腹腔镜术中应用布林佐胺滴眼液可降低眼压,预防视神经损伤,且对呼吸循环系统没有影响。Objective To investigate the effects of Brinzolamide on the intraocular pressure（ IOP）during gynecological laparoscopic surgery. Methods Sixty cases of ASA grade Ⅰ or Ⅱ gynecological patients with uterine fibroids underwent laparoscopic hysterectomy were divided into two groups： the brinzolamide group（ n = 30） and the control group（ n = 30） according to different modus operandi. IOP,heart rate（ HR）,mean arterial pressure（ MAP）,end-tidal carbon dioxide partial pressure（ PETCO2） and airway pressure（ Paw） were measured 5 min after anesthesia（ T0）,30 min（ T1）,60 min（ T2） and 120min（ T3） after brinzolamide eye drops（ brinzolamide） treatment,pneumoperitoneum（ PP） or abdominal wall was suspended,30 min after deflation or abdominal wall was put down（ T4）. Results IOP of the group A and group B were increased significantly at T1,T2 and T3. There were statistically significant differences in the interaction between group and time points as well as between groups（ P〈0. 05）. MAP,HR,PETCO2 and Paw of the group A and group B were increased significantly at T1,T2,T3. There were significant differences between the time points（ P〈0. 05）. Conclusion Brinzolamide can effectively prevent the intraocular hypertension during gynecological laparoscopic surgery, prevent optic nerve injury,and has no effect on the respiratory and circulatory system.

关 键 词：眼内压 妇科腹腔镜 布林佐胺滴眼液 

分 类 号：R738.7[医药卫生—肿瘤] R443.8[医药卫生—临床医学]