复方樟柳碱改善玻璃体切割术后眼底血液循环的临床研究

Effect of compound anisodine on fundus blood circulation after vitrectomy with face-down posture

目的:探讨复方樟柳碱对于玻璃体切割术后面向下体位患者的眼底血液循环的作用。方法:前瞻性随机对照研究。对60例60眼孔源性视网膜脱离接受玻璃体切割联合硅油填充手术的患者术前采用随机对照方法,分为试验组30例,空白对照组30例,试验组患者于术后第1d起给予复方樟柳碱注射液2mL,连续14d,每日术眼侧颞浅动脉旁皮下注射1次。术后第1d,术后1wk和2wk使用海德堡视网膜血流仪进行眼底扫描,记录相同部位视网膜微循环血流参数,并进行比较。结果:比较术后1wk和2wk与术后第1d测得的血流参数(Vol,Flw,Vel),空白对照组术后1wk和2wk的血流参数均较术后第1d明显减少,试验组术后1wk和2wk的血流参数均较术后第1d增加,试验组与空白对照组比较在统计学上有显著统计学差异(P<0.01)。结论:玻璃体切割术硅油填充眼患者术后保持面向下体位,可能会造成视网膜供血的减少,继发眼底缺血改变;复方樟柳碱能有效改善玻璃体切割术后面向下体位患者的视网膜脉络膜微循环,对减少继发性眼底缺血、增强患者视功能具有较好的辅助作用。

AIM： To investigate the effect of compound anisodine on fundus blood circulation after vitrectomy with face- down position.METHODS： Sixty patients（ 60 eyes） with rhegmatogenous retinal detachment received vitrectomy with silicone oil tamponade operation, who were randomized divided into treatment group（ 30 eyes） and control group（ 30 eyes）. The patients in the treatment group received the subcutaneously injection of compound anisodine hydrobromide by the superficial temporal artery once daily for 14 d since postoperative first day. Retinal microcirculation blood flow parameters were recorded with Heidelberg retinal flowmeter postoperative 1d,1 and2 wk,and were compared between two groups.RESULTS： The blood flow parameters（ Vol,Flw,Vel） of control group postoperative 1 and 2wk were significantly less than those postoperative 1d. Otherwise the parameters of treatment postoperative 1 and 2wk were significantly more than those postoperative 1d. The parameters between two groups were significant different（ P 0.01）.CONCLUSION： Facing down after vitrectomy with silicone oil tamponade may reduce retinal blood supply,consequently lead to retinal ischemia; compound anisodine can effectively improve the retinal and choroidal microcirculation after vitrectomy with face- down posture,reduce retinal ischemia,and enhance the visual function.