彩色多普勒超声对巩膜扣带术后球后血流动力学的研究

Retrobulbar Hemodynamic Changes with Scleral Buckling Procedures by CDFI

为研究巩膜扣带术后后睫状动脉（ＰＣＡ）、视网膜中央动脉（ＣＲＡ）球后血流动力学的改变，不同术式对眼部血流动力学的影响及ＰＣＡ、ＣＲＡ球后血流动力学改变的相关因素分析，对５０例孔源性视网膜脱离患者术前、术后不同时期行彩色超声多普勒检测。结果：巩膜扣带术后ＰＣＡ、ＣＲＡ的收缩期最大血流速度（Ｖｍａｘ）、舒张期末最小血流速度（Ｖｍｉｎ）较对照组下降，而阻力指数（ＲＩ）较对照组增加，经配对ｔ检验有显著性差异（Ｐ值＜０．０５）。环扎＋外加压可明显影响ＰＣＡ、ＣＲＡ的血流量，而单纯外加压术则无明显影响。ＰＣＡ、ＣＲＡ的Ｖｍａｘ改变与环扎带缩短率呈负相关。认为巩膜环扎术可导致眼血流量下降。

To study retrobulbar circulatory changes of the posterior ciliary artery (PCA) and cental retinal artery (CRA) with scleral buckling procedures; to study affects of retrobulbar hemodynamics with different surgerys; to analyse the correlation among retrobulbar circulatary changes. Methods: We prospectively enrolled 50 patients with rhegmatogenous retinal detachment repired by scleral buckling. We measured hemodynamic indexs in the PCA, CRA at 24 hours before the operation and on first, fifteenth postoperative day by color Doppler imaging. RESULTS: Postoperatively peak systolic (Vmax), end diastolic (Vmin) of PCA, CRA were significantly reduced, resistence index (RI) of PCA, CRA were remarkable rised comparing with the contral. There were significantly decrease blood flow of PCA, CRA. But local scleral buckling did not significantly decrease blood flow. A nigative correlation existed between the Vmax of PCA, CRA and the short rate of encircling band. Conclusions: Scleral buckling procedures with encircling elements can decrease blood flow of eye.