腹腔镜手术术中体位及时间对患者眼内压的影响  

Effect of body position and time on intraocular pressure in patients undergoing laparoscopic surgery

作　　者：刘洪玮 姚福旺 韩美娟 张雷[1] 单靖华[1] LIU Hongwei;YAO Fuwang;HAN Meijuan;ZHANG Lei;SHAN Jinghua(Department of Anesthesiology,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院麻醉科,山东潍坊261031

出　　处：《潍坊医学院学报》2022年第2期133-135,共3页Acta Academiae Medicinae Weifang

基　　金：潍坊市软科学课题(项目编号:2021RKX034)。

摘　　要：目的探讨妇科腹腔镜手术不同头低位角度和时长对患者眼内压(IOP)的影响。方法纳入符合标准的患者160例,均在全身麻醉下择期行腹腔镜全子宫切除术。随机分为A组和B组,各80例,A组取头低位10°,B组取头低位20°。记录两组患者术中各时间点的IOP值,即麻醉诱导后气腹前(T_(0))、气腹后1min(T_(1))、头低脚高位即刻(T_(2))、头低脚高位30min(T_(3))、头低脚高位60min(T_(4))、恢复水平位即刻(T_(5))、恢复水平位5min(T_(6))、恢复水平位10min(T_(7))以及头低位总时长。结果①T_(2)~T_(7)时刻,B组各时间点IOP值均高于A组(P<0.05)。②T_(2)~T_(4)时刻,两组患者的IOP值逐渐增高(P<0.05),T_(5)~T_(7)时刻,两组患者IOP值缓慢下降,但仍高于各组T_(0)时刻的IOP值(P<0.05)。③在T_(7)时,与A组比较,B组MAP值较高,差异有统计学意义(P<0.05);在T_(0)~T_(6)时,两组MAP值差别比较,差异无统计学意义(P>0.05)。两组患者头低位时长比较,差异无统计学意义(P>0.05)。结论妇科腹腔镜手术头低位角度增大,头低位时间延长,可导致眼内压进一步升高。Objective To investigate the effect of different head-down angles and durations of gynecological laparoscopic surgery on intraocular pressure(IOP).Methods One hundred and sixty patients who met the criteria were treated with laparoscopic total hysterectomy under general anesthesia.They were randomly divided into group A and group B,each with 80 cases.Patients in group A was taken the low head position of 10°and patients in group B was taken the low head position of 20°.The IOP values of patients in the two groups at each time point during the operation were recorded,namely before pneumoperitoneum(T_(0)),1 min after pneumoperitoneum(T_(1)),immediately after headlow foot-high position(T_(2)),30min after head-low and foot-high position(T_(3)),60min after head-low and foot-high position(T_(4)),immediately after recovery of horizontal position(T_(5)),5 min after recovery of horizontal position(T_(6)),10min after recovery of horizontal position(T_(7)),and the total time of head low position.Results①At the time of T_(2) to T_(7),the IOP values of patients in group B were higher than those in group A.②At the T_(2) to T_(4) time,the IOP value of the patients in two groups gradually increased(P<0.05).At the time of T_(5) to T_(7),the IOP value of the patients in the two groups decreased slowly,but it was still higher than the IOP value at T_(0) moment in each group(P<0.05).③Compared with the A group,the MAP values in the B group were higher in T_(7) and the difference was statistically significant(P<0.05),but there was no statistical difference at T_(0) or T_(6)(P>0.05).The difference was not statistically significant when comparing the time of head-down between the two groups(P>0.05).Conclusion Gynecological laparoscopic surgery increases the head down angle and prolongs the head down time,which can lead to further increase of intraocular pressure.

关 键 词：妇科腹腔镜 全身麻醉 头低位 眼内压 

分 类 号：R614[医药卫生—麻醉学]