鼻内镜手术后鼻腔填塞及体位改变对眼压的影响研究  

Effect of Nasal Packing and Postural Change on Intraocular Pressure after Endoscopic Sinus Surgery

作　　者：朱魏[1] 蒋忠[1] 

机构地区：[1]南京鼓楼医院麻醉科,江苏省南京市210008

出　　处：《实用心脑肺血管病杂志》2016年第B12期134-136,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨鼻内镜手术后鼻腔填塞及体位改变对眼压的影响。方法选择2014年9月—2015年9月南京鼓楼医院美国麻醉医师协会（ASA）Ⅰ级或Ⅱ级行双侧鼻内镜手术的患者25例,分别于麻醉后术前5min（T0）、鼻腔填塞前5min（T1）、鼻腔填塞后5min（T2）、鼻腔填塞后10min（T3）、鼻腔填塞后15min（T4）、上身抬高15°后5min（T5）、上身抬高15°后10min（T6）记录患者眼压、平均动脉压、心率、气道压。结果 25例患者均在仰卧位下顺利完成手术,手术时间1.5-3.0h,术中出血量200-300ml。患者各时间点平均动脉压、心率、气道压比较,差异均无统计学意义（P〉0.05）。患者各时间点眼压比较,差异有统计学意义（P〈0.05）;其中T2、T3、T4时眼压较T0时升高,T5、T6时眼压较T2、T3、T4时降低,T6时眼压较T5时降低,差异有统计学意义（P〈0.05）。结论鼻内镜手术后因鼻腔填塞,眼压明显上升,术后抬高上半身15°是预防鼻腔填塞后眼压升高的有效手段。Objective To investigate the effect of nasal packing and postural change on intraocular pressure after endoscopic sinus surgery. Methods Twenty-five patients（ ASA Ⅰ/Ⅱ） undergoing bilateral endoscopic sinus surgery in Nanjing Drum Tower Houspital from September 2014 to September 2015 were collected. Intraocular pressure, mean arterial pressure,heart rate,airway pressure were recorded at 5min prior to surgery after anesthesia（ T0）,5min prior to nasal packing（ T1）,5min after nasal packing（ T2）,10 min after nasal packing（ T3）,15 min after nasal packing（ T4）,semireclining position（ 15° upper body elevation） for 5min（ T5）, semireclining position for 10min（ T6）. Results 25 patients were successfully performed in supine position, operation time was 1. 5-3. 0 h, amount of bleeding during operation was 200-300 ml. The differences of mean arterial pressure, heart rate, airway pressure among difference times were not statistically significant（ P 〉 0. 05）; the difference of intraocular pressure among difference times was not statistically significant（ P 〈0. 05）; the intraocular pressure in T2,T3,T4 was higher than that in T0,the intraocular pressure in T5,T6 was lower than that in T2,T3,T4,the intraocular pressure in T6 was lower than that in T5,the difference was statistically significant（ P 〈0. 05）. Conclusion Nasal packing after endoscopic sinus surgery can increased intraocular pressure. 15° upper body elevation can prevent the increase in intraocular pressure caused by nasal packing following endoscopic sinus surgery.

关 键 词：自然腔道内镜手术 眼压 内填塞 体位 

分 类 号：R765.04[医药卫生—耳鼻咽喉科]