天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1088-1091.doi: 10.11958/20170936

• 临床研究 • 上一篇    下一篇

玻璃体切割术对视网膜脱离眼球供血的影响

王勇 1，张珑俐 1△，胡博杰 1，韩金栋 1，边领斋 2，李筱荣 1   

  1. 1 天津医科大学眼科医院，天津医科大学眼视光学院，天津医科大学眼科研究所（邮编 300384）；2 天津市环湖医院
  • 收稿日期:2017-09-04 修回日期:2017-09-24 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 王勇 E-mail:niniwangyong@126.com
  • 作者简介:王勇（1980），女，博士研究生在读，主治医师，主要从事玻璃体视网膜疾病治疗方面研究

The influence of vitrectomies on the blood supply of the eyeball in patients with rhegmatogenous retinal detachment

WANG Yong1, ZHANG Long-li1△, HU Bo-jie1, HAN Jin-dong1, BIAN Ling-zhai2, LI Xiao-rong1   

  1. 1 Tianjin Medical University Eye Institute, the School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin 300384, China; 2 Tianjin Huanhu Hospital
  • Received:2017-09-04 Revised:2017-09-24 Published:2017-10-15 Online:2017-10-13

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摘要： 目的 探讨裂孔源性视网膜脱离（RRD）玻璃体切割术后对眼球供血的影响。方法 回顾性分析我院经 孔源性视网膜脱离玻璃体切割手术治疗的 50 例眼孔源性视网膜脱离患者 50 只眼（RD 眼）术前、术后平均 3 个月经 彩色多普勒超声血流显像技术（CDFI）检测的视网膜中央动脉（CRA）、睫状后短动脉（sPCA）、眼动脉（OA）的收缩期 峰值流速（PSV）、舒张末期血流速度（EDV）、阻力指数（RI）的变化。其中 22 只眼行硅油填充，28 只眼行 12%C3F8 填 充，22 只硅油填充眼于术后 2～3 个月行硅油取出术后 2 周再行 CDFI 血流参数检测。术前取患者对侧眼为对照 眼。结果 术前 RD 眼的 CRA、sPCA、OA 的 PSV、EDV、RI 较对照眼无明显改变。玻璃体切割术后 3 个月 RD 眼 CRA 的 PSV、EDV 与 3 个月前相比显著增加，RI 却出现明显的降低，差异有统计学意义（P＜0.05）。sPCA 及 OA 各 项血流参数手术前后比较差异均无统计学意义（P＞0.05）。术后对照眼 CRA、sPCA、OA 的各项血流参数与术前相比 差异无统计学意义（P＞0.05）。结论 玻璃体切割手术可以提高 RRD 眼术后 CRA 的血流速度，降低视网膜血管的 RI，改善眼视网膜的血流供应。

关键词: 视网膜脱离, 玻璃体切除术, 超声检查, 多普勒, 彩色, 孔源性视网膜脱离, 经睫状体平坦部玻璃体切 割术

Abstract: Objective To analyse the retrobulbar haemodynamic changes after vitrectomy in patients with rhegmatogenous retinal detachment (RRD). Methods Color Doppler flow imaging (CDFI) was used for measurement of blood flow velocities including peak systolic velocity (PSV), end diastolic velocity (EVD) and resistive indexes (RI) of the ophthalmic artery (OA), posterior ciliary arteries (sPCA) and central retinal artery (CRA) in 50 eyes of 50 patients with RRD. In them 22 eyes were filled with silicone oil, 28 eyes were filled with 12%C3F8 and 22 eyes were operated to remove silicone oil after filled with silicone oil for 2-4 months, and then CDFI parameters were obtained. The contralateral eyes were used as control eyes before and after the operation. Results There were no significant differences in CRA and sPCA, and PSV, EDV and RI before treatment between RD and OA eyes and control eyes (P＞0.05). PSV and EVD of CRA were significantly increased 3 months after surgery, RI were decreased significantly (P＜0.05). There were no significant differences in blood flow parameters of OA and sPCA before and after surgeries (P＞0.05). No changes were found in control eyes 3 months after surgery. Conclusion VRS might increase the velocity of CRA, decrease RI and improve ocular blood supply postoperatively.

Key words: retinal detachment, vitrectomy, ultrasonography, doppler, color, rhegmatogenous retinal detachment, pars plana vitrectomy surgery