不同麻醉方式下小梁切除术对新生血管性青光眼患者血清PEDF和VEGF水平的影响  

Effects of trabeculectomy under different anesthesia on serum PEDF and VEGF levels in patients with neovascular glaucoma

作　　者：田洁[1] 杨倩[2] 李春擎 周伟娜[3] TIAN Jie;YANG Qian;LI Chunqing;ZHOU Weina(Department of Anesthesiology,Baoding First Central Hospital of Hebei Province,Baoding,Hebei,China,071000;Department of Ophthalmology,Baoding First Central Hospital of Hebei Province,Baoding,Hebei,China,071000;Department of Ultrasound,Baoding First Central Hospital of Hebei Province,Baoding,Hebei,China,071000)

机构地区：[1]河北省保定市第一中心医院麻醉科,河北保定071000 [2]河北省保定市第一中心医院麻醉科眼科,河北保定071000 [3]河北省保定市第一中心医院麻醉科彩超室,河北保定071000

出　　处：《分子诊断与治疗杂志》2023年第2期306-309,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题(20190443)。

摘　　要：目的 探究不同麻醉方式下(球周麻醉与单纯表面麻醉)小梁切除术对新生血管性青光眼患者血清色素上皮衍生因子(PEDF)、血管内皮生长因子(VEGF)水平的影响。方法 选取2021年1月至2022年6月于保定市第一中心医院行小梁切除术的新生血管性青光眼患者96例为研究对象,采用随机数字表法分为球周麻醉组与表面麻醉组,各48例。球周麻醉组采用球周麻醉后进行小梁切除术,表面麻醉组于单纯表面麻醉后进行小梁切除术。通过视觉模拟评分法(VAS)评估两组麻醉效果,比较两组患者新生血管消退时间、术前与术后7 d血清白介素-6(IL-6)、PEDF、VEGF水平及眼压,统计两组并发症发生情况。结果 两组VAS评分比较,差异无统计学意义(t=0.736,P>0.05);球周麻醉组新生血管消退时间短于表面麻醉组,差异均具有统计学意义(t=2.083,P<0.05);术后7 d,两组IL-6、VEGF水平及眼压均降低,且球周麻醉组低于表面麻醉组,PEDF水平均升高,且球周麻醉组高于表面麻醉组,差异均具有统计学意义(t=2.184、4.353、5.293、4.929,P<0.05);两组并发症发生率比较,差异无统计学意义(χ^(2)=0.844,P>0.05)。结论 球周麻醉与单纯表面麻醉下小梁切除术对新生血管性青光眼的麻醉效果与安全性相当,球周麻醉更能降低眼压,平衡机体血管生成促进/抑制因子水平。Objective To investigate the effect of trabeculectomy under different anesthesia methods(peribulbar anesthesia and simple topical anesthesia)on serum pigment epithelium-derived factor(PEDF) and vascular endothelial growth factor(VEGF) levels in patients with neovascular glaucoma.Methods A total of 96 patients with neovascular glaucoma who underwent trabeculectomy in Baoding First Central Hospital from January 2021 to June 2022 were selected as the research subjects,and divided into a peribulbar anesthesia group and a topical anesthesia group by random number table method(48 cases each). The peribulbar anesthesia group was treated with peribulbar anesthesia followed by trabeculectomy,and the topical anesthesia group was treated with simple topical anesthesia plus subconjunctival infiltration anesthesia followed by trabeculectomy. Visual analogue scale(VAS)was used to evaluate the effect of anesthesia in the two groups,and the regression time of neovascularization,serum interleukin-6(IL-6),PEDF,VEGF levels and intraocular pressure before and 7 days after operation were compared between the two groups. The incidence of complications between the two groups was compared. Results There was no significant difference in the VAS score between the two groups(t=0.736,P>0.05). The neovascularization time in the peribulbar anesthesia group was shorter than that in the topical anesthesia group,and the difference was statistically significant(t=2.083,P<0.05). The levels of IL-6,VEGF and intraocular pressure were decreased,and the peribulbar anesthesia group was lower than the topical anesthesia group,the PEDF level was increased,and the peribulular anesthesia group was higher than the topical anesthesia group,the differences were statistically significant(t=2.184、4.353、5.293、4.929,P<0.05). There was no significant difference in the incidence of complications between the two groups(χ^(2)=0.844,P>0.05). Conclusion Peribulbar anesthesia and trabeculectomy under simple surface anesthesia have the same anesthesia effect and s

关 键 词：小梁切除术 新生血管性青光眼 球周麻醉 单纯表面麻醉 

分 类 号：R614[医药卫生—麻醉学]