体外循环心脏直视手术眼压变化的观察

Observation of Intraocular Pressure during Cardiopulmonary Bypass

目的探讨体外循环心脏直视手术（ｃａｒｄｉｏｐｕｌｍｏｎａｒｙｂｙｐａｓｓｓｕｒｇｅｒｙ，ＣＰＢＳ）患者眼压（ｉｎｔｒａｏｃｕｌｅｒｐｒｅｓ－ｓｕｒｅ，ＩＯＰ）变化及术后缺血性视神经病变的原因。方法对２３例心脏病患者使用Ｓｃｈｉｔｚ眼压计分别在体外循环、转机前、转机中及停机后测量眼压。结果体外循环转机５、１０、１５及２５ｍｉｎ时眼压升高；转机４５ｍｉｎ时眼压回落接近转机前水平，转机中患者血压、红细胞压积和血清蛋白含量下降。结论在体外循环心脏直视手术中由于血液稀释、胶体渗透压下降及眼血流量增加导致眼压升高，转机中血压也明显下降，推测术后缺血性视神经病变可能与此有关。

ObjectiveTo investigate changes in intraocular pressure (IOP) during cardiopulmonary bypass surgery (CPBS).MethodsIOPs was measured before,during and after CPBS with Schiotz tonometer in 23 patients undergoing CPBS.We also measured the packed cell volume,the content of albumin,blood gas analysis,perfusion pressure of radial artery and central venous pressure.ResultsThe mean IOP was significantly higher at 5,10,15 and 25 min during extracorporeal circulation than before extracorporeal circulation ( P <0.05).The mean IOP returned the level of pre extracorporeal circulation at 45 min during CPBS.ConclusionDuring CPBS,haemodilution caused an increase in ocular blood flow and a low colloidal osmotic pressure,which resulted a temporary increase in IOP.The blood pressure was significantly reduced during extracorporeal circulation.It is suggested that both IOP increase and blood pressure decrease may be associated with ischemic optic neuropathy complicating CPBS.