血液透析后血浆渗透压改变对眼压的影响

Effects of plasma osmotic pressure on intraocular pressure after hemodialysis

为了探讨维持性血液透析（血透）患者在血透后出现一过性视力下降，眼胀痛等症状是否与血浆渗透压改变有关。方法用Ｓｃｈｉｏｔｚ眼压计在血透前后及治疗中每隔一小时测量一次眼压。检测了前房角，视野及眼压描记及血浆渗透压、血生化等。结果血透后血浆渗透压下降会导致眼压升高。有青光眼解剖特点的眼球，眼压会出现进行性病理升高或诱发青光眼。结论对眼球有青光眼解剖特点的患者在血透时避免大量脱水。血透治疗充分，使治疗后内环境保持相对稳定，可避免眼压的升高。

Objective To study whether or not the symptoms, such as transient hypopsia, ophthalmagra etc, were related to the alteration of plasma osmotic pressure of the patients after maintaining dialysis. Methods The intraocular pressures of the patients were measured before and after dialysis and once an hour in the dialysis session. The anterior chamber angle、 field of view、intraocular pressure and plasma osmotic pressure were checked. Results Fall of the plasma osmotic pressure after dialysis would result in the elevation of intraocular pressure. For the eyeball with anatomic characteristic of glaucoma, the intraocular pressure presented a pathological elevation or induced glaucoma. Conclusion Massive dehydration during dialysis should be avoided for patients with anatomic characteristic of glaucoma. After effective dialysis, their internal environment could maintain relative stability and the elevation of intraocular pressure may be avoided.