高频彩超在眼部缺血综合征病人颈动脉血管重建术治疗中的应用价值

Application value of high frequency color Doppler ultrasound in carotid artery reconstruction of patients with ocular ischemic syndrome

目的:研究高频彩超在眼部缺血综合征(OIS)病人颈动脉血管重建术治疗中的应用价值。方法:选取2018年7月至2019年7月行颈动脉血管重建术的OIS病人50例,根据病人眼动脉血流方向不同分为正向血流组(正向组)28例和反向血流组(反向组)22例。分别比较2组病人手术前后平均颈动脉狭窄度、眼部最佳矫正视力及眼动脉、视网膜中央动脉和睫状后动脉的血流动力学改变。结果:治疗前后,反向组病人平均颈动脉狭窄度均高于正向组(P<0.01);治疗后,2组病人平均颈动脉狭窄度均比治疗前降低(P<0.01)。治疗前,反向组病人眼动脉PSV高于正向组,睫状后动脉PSV低于正向组(P<0.05和P<0.01);治疗后,2组病人眼动脉、睫状后动脉、视网膜中央动脉的PSV均比治疗前升高(P<0.01),且治疗后正向组眼动脉和睫状后动脉PSV高于反向组(P<0.05和P<0.01)。治疗前后,正向组病人最佳矫正视力均高于反向组(P<0.01);治疗后,正向组病人最佳矫正视力高于治疗前(P<0.01)。结论:行颈动脉血管重建术后OIS病人平均颈动脉狭窄度及眼动脉、视网膜中央动脉和睫状后动脉的血流动力学均明显改善,且正向组视力明显提高,而反向组无明显改善;高频彩超可准确监测病人手术前后球后主要血管血流动力学的改变,有利于实时掌握病人病情改善情况。

Objective:To study the value of high frequency color Doppler ultrasound in carotid artery reconstruction in patients with ocular ischemic syndrome(OIS).Methods:A total of 50 patients with OIS who underwent carotid artery reconstruction from July 2018 to July 2019 were selected and divided into forward flow group(28 cases)and reverse flow group(22 cases)according to the direction of ophthalmic artery blood flow.The mean carotid stenosis,best corrected visual acuity and hemodynamic changes of ophthalmic artery,central retinal artery and posterior ciliary artery were compared between the two groups before and after operation.Results:Before and after treatment,the average degree of carotid stenosis in the reverse flow group was higher than that in the forward flow group(P<0.01).After treatment,the average degree of carotid stenosis in the two groups was lower than that before treatment(P<0.01).Before treatment,the PSV of ophthalmic artery in the reverse flow group was higher than that in the forward flow group,and the PSV of posterior ciliary artery was lower than that in the forward flow group(P<0.05 and P<0.01).After treatment,the PSV of ophthalmic artery,posterior ciliary artery and central retinal artery in the two groups were higher than that before treatment(P<0.01),and the PSV of ophthalmic artery and posterior ciliary artery in the forward flow group was higher than that in the reverse flow group(P<0.05 and P<0.01).Before and after treatment,the best corrected visual acuity in the forward flow group was higher than that in the reverse flow group(P<0.01).After treatment,the best corrected visual acuity in the forward flow group was higher than that before treatment(P<0.01).Conclusions:After carotid revascularization,the mean carotid stenosis and hemodynamics of ophthalmic artery,central retinal artery and posterior ciliary artery in OIS patients are significantly improved,and the visual acuity in the forward flow group is significantly improved,but not in the reverse flow group.High frequency color Doppler ultrasound can accurately monitor the changes of hemodynamics of main postbulbar blood vessels before and after operation,which is helpful to grasp the improvement of patients′condition in real time.