白内障术后早期接受散瞳处理的NPDR并白内障患者瞳孔直径及眼部血流动力学变化  

Changes of pupil diameter and ocular hemodynamics in NPDR patients with cataract undergoing mydriasis after phacoemulsification and intraocular lens implantation

作　　者：陈妍鹏[1] 仝真真 赵亭亭 吕红娟 李毅[1] CHEN Yanpeng;TONG Zhenzhen;ZHAO Tingting;LYU Hongjuan;LI Yi(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《山东医药》2020年第30期31-34,共4页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题计划资助项目(20180874)。

摘　　要：目的观察白内障超声乳化摘除联合人工晶状体植入术后早期接受散瞳处理的非增殖性糖尿病视网膜病变(NPDR)并白内障患者瞳孔直径及眼部血流动力学变化。方法100例NPDR合并白内障患者(共100眼),均行白内障超声乳化摘除联合人工晶状体植入术治疗,术后随机分为观察组、对照组各50例,观察组于术后每天(以手术次日为术后第1天)同时刻予复方托吡卡胺滴眼液散瞳1次,对照组于术后第7、14天同时刻散瞳1次,观察两组眼部血流动力学指标、散瞳后瞳孔直径、散瞳时间,于术后第14天计算两组瞳孔达标情况。结果与对照组相比,术后第7、14天观察组视网膜中央动脉、睫状后短动脉的舒张末期血流速度(EDV)、收缩期速度峰值(PSV)升高,阻力指数(RI)下降(P均<0.05);与第7天比较,术后第14天观察组视网膜中央动脉、睫状后短动脉的EDV、PSV上升,RI下降,对照组视网膜中央动脉及睫状后短动脉的EDV、PSV降低,RI升高(P均<0.05)。与对照组比较,术后第7、14天观察组瞳孔直径长,散瞳时间短(P均<0.05)。与第7天比较,术后第14天观察组瞳孔直径长、散瞳时间短(P均<0.05)。与对照组相比,术后第14天观察组瞳孔达标率、基本达标率更高(P均<0.05)。结论白内障超声乳化摘除联合人工晶状体植入术后早期每日接受散瞳处理的NPDR并白内障患者的视网膜中央动脉及睫状后短动脉的EDV、PSV平均值降低,RI平均值升高,且瞳孔直径长、散瞳时间短,患者瞳孔接近或达到进一步眼底诊疗所需的散瞳直径。Objective To observe the changes of pupil diameter and ocular hemodynamics in non-proliferative diabetic retinopathy(NPDR)patients with cataract who underwent mydriasis in the early stage after phacoemulsification and intraocular lens implantation.Methods Totally 100 patients with NPDR complicated with cataract(100 eyes)were treated with phacoemulsification and intraocular lens implantation.Then,they were randomly divided into the observation group and control group,with 50 cases in each group.The patients in the observation group were given compound tropicamide eye drops for mydriasis at the same time every day after operation(the next day as the first day after operation).In the control group,mydriasis was performed once at the same time on day 7 and 14 after operation.The ocular hemodynamic indexes,pupil diameter and pupillary time after mydriasis were observed in the two groups,and the pupil compliance of the two groups was calculated on the 14th day after operation.Results Compared with the control group,the mean value of end diastolic blood flow velocity(EDV)and peak systolic velocity(PSV)of central retinal artery and short posterior ciliary artery in the observation group increased on the 7th and 14th days after operation,and the average value of resistance index(RI)decreased(all P<0.05);the EDV and PSV of the central retinal artery and short posterior ciliary artery in the observation group increased and RI decreased on the 14th day after operation as compared with those on the 7th day,while the average values of EDV and PSV of the central retinal artery and short posterior ciliary artery in the control group decreased,and the average RI value increased(all P<0.05).Compared with the control group,the observation group had longer pupil diameter and shorter mydriasis time on the 7th and 14th days after operation(all P<0.05).Compared with the 7th day,the pupil diameter was longer and the mydriasis time was shorter in the observation group on the 14th day after operation(all P<0.05).Compared with the control

关 键 词：瞳孔直径 视网膜中央动脉 睫状后短动脉 舒张末期血流速度 收缩期速度峰值 糖尿病视网膜病变 白内障 白内障超声乳化摘除术 人工晶状体植入术 

分 类 号：R776.1[医药卫生—眼科]