【摘要】 目的：观察一定范围环扎带缩短率的孔源性视网膜脱离巩膜扣带术术前、术后眼血流动力学的改变。方法：采用彩色多普勒成像(CDI)对28例单眼视网膜脱离患者术前、术后的视网膜中央动脉(CRA)的收缩期峰值流速(Vmax)、舒张期末流速(Vmin)、平均血流速度(V)，阻力指数(RI)、搏动指数(PI)进行测量，以对侧正常眼作对照。结果：术前患眼与对照眼的CRA各项指标比较，差异无统计学意义。术后14d视网膜脱离眼CRA的Vmax，Vmin均升高，RI，PI亦增高，与对照眼以及术前指标差异无统计学意义。结论：一定范围环扎带缩短率的环扎加压术术后短期内视网膜血供受无影响, 彩色多普勒超声是检测眼部血流变化的较理想方法。
【关键词】 视网膜脱离;血流动力学;彩色多普勒成像
Research on the hemodynamics behind the eyeball by color Doppler imaging after scleral buckling
JunQi Lu1, Jiong Lu2, JinYu Wang2
1Department of Ophthalmology, Changshu Municipal Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine Affiliated Changshu Hospital, Changshu 215500, Jiangsu Province, China;2Department of Ophthalmology, Changshu No.2 Peoples Hospital, Changshu 215500, Jiangsu Province, China
Correspondence to: JunQi Lu. Department of Ophthalmology, Changshu Municipal Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine Affiliated Changshu Hospital, Changshu 215500, Jiangsu Province, China. [email protected]
Received:20100528 Accepted:20100609
Abstract
AIM: To observe the ocular hemodynamic changes in the eyes of patients with rhematigenous retinal detachment before and after the scleral encircling procedure with the encircling band shorten in a certain range.
METHODS: Central retinal arteries (CRA)were studied with color Doppler imaging (CDI) in 28 patients with unilateral rhematogenous retinal detachment, the fellow eyes served as control.The measured parameters included peak systolic velocity(Vmax),end diastolic velocity(Vmin)，mean velocity(V)，resistance index(RI) and pulsatility index(PI).
RESULTS: A comparison of the indexes of CRA in both the sick eyes before the operations and the eyes in the control group found the differences among them no statistical significance. The Vmax, Vmin, RI and PI of the CRA of the sick eyes all increased 14 days after the operations, but not reached statistical significant difference, and showed no statistical significance as compared with those in the control group.
CONCLUSION: Scleral buckling procedure with the encircling band shorten in a certain range can not change blood flow in retinal tissue for a short time after surgery. Color Doppler imaging is a useful tool for the studies of ocular hemodynamics changes.
KEYWORDS: retinal detachment;hematodynamics;color Doppler imaging
Lu JQ, Lu J, Wang JY. Research on the hemodynamics behind the eyeball by color Doppler imaging after scleral buckling. Int J Ophthalmol
(Guoji Yanke Zazhi) 2010;10(9):17811782
巩膜扣带术是目前治疗非复杂性视网膜脱离主要的手术方式，手术复位率达90%以上，但患眼术后视功能的恢复不够理想，有人认为手术使眼球正常解剖结构发生改变，引起球后血流动力学的改变所致，但研究结果不尽相同。视网膜中央动脉(CRA)是营养视网膜的终末血管，与视神经有密切的关系，它的血流动力学改变，影响着视网膜的生理功能。我们采用彩色多普勒成像(CDI)血流显像技术，对视网膜脱离患者术前、术后的CRA的血流动力学改变进行观察，报告如下。
1对象和方法
1.1对象
视网膜脱离组：单眼孔源性视网膜脱离患者,采用巩膜扣带术一次性手术成功，环扎带缩短率16%～21%(平均17%)，另1眼正常;男15例，女13例;年龄30～69(平均47)岁，右10眼，左18眼，脱离范围1个象限11眼，2个象限12眼，3个象限3眼，4个象限2眼;视力：光感～0.05者13眼，0.06～0.1者6眼，0.12～0.3者7眼，>0.3者2眼。裂孔均为单发周边孔，在1PD大小内，已排除高血压、糖尿病、青光眼、既往有眼部手术史及合并脉络膜脱离患者。对照组：以同期对侧眼为对照组。
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