摘要
目的通过使用笔式眼压计观察支撑喉镜下声带息肉切除术中眼内压的变化情况。方法选择ASA分级Ⅰ～Ⅱ级行支撑喉镜下声带息肉切除术患者，使用笔式眼压计分别于全麻后平卧位5min（T1）、手术前颈过伸位5min（T2）、手术结束时颈过伸位（B）、手术后恢复平卧位5min（T4）、手术结束后20min（T5）测量眼内压，同时观测各时间点平均动脉压（MAP）、心率（HR）、呼气末二氧化碳分压（PnCO2）、气道压（PAW）的变化。结果术中各时间点MAP、HR、PEICO2、PAW比较，差异均无统计学意义。患者T1眼内压[（11．9±1．7）mmHg（1mmHg=0．133kPa）]在正常范围，T2[（19．0±1．8）mmHg]较T1明显升高（P〈0．05），T3[（25．7±1．9）mmHS]较T2进一步升高（P〈0．05），达到最高水平，T4[（17．8±1．9）mmHg]较T3降低（P〈0．05），T5[（12．1±1．5）mmHg]较T4降低（P〈0．05），至术前水平。结论患者眼内压从手术开始前颈过伸位逐渐升高，手术结束时颈过伸位达到最高，手术后恢复平卧位眼内压逐渐降低回至术前水平。
Objective To observe the variations in intraoeular pressure （IOP） in vocal cord polyp resections supported by pedestal laryngoscope with Tono-Pen tonometer. Methods The IOP of patients （grade Ⅰ - Ⅱ by ASA） who underwent vocal cord polyp resections supported by pedestal laryngoscope were detected by Tono-Pen tonometer 5 minutes later on supine position before the operation （T1）, 5 minutes later on cervical hyperextension position before the operation （T2） ,5 minutes later on cervical hyperextension position after the operation （T3）, 5 minutes later on supine position after the operation （T4）, 20 minutes later on supine position after the operation （T5） after general anesthesia respectively. At each point the changes of mean arterial pressure （MAP）,heart rate （HR）,end-tidal carbon dioxide partial pressure（PErCO2）,and airway pressure （PAW） were observed as well. Results There were no differences in MAP,HR,PErCO2, PAW at eachpoint statistically. The IOP increased significantly at T2,T3,T4 compared with IOP at T1[ （ 19.0 ± 1.8）,（25.7 ± 1.9）,（17.8 ± 1.9） mm Hg （1 mm Hg= 0.133 kPa） vs （11.9 ± 1.7） mm Hg]（P〈 0.05）. The differences between IOP at T2 and T3 were manifest （P〈 0.05）. So it was the situation when the IOP at T3 and T4,T4 and T5 were compared （P 〈 0.05）. The IOP at T5 was （ 12.1 ± 1.5） mm Hg,there was no difference compared with T1. Conclusion The IOP increases gradually from the point when the patient put on cervical hyperextension position before the operation after general anesthesia and achieves the summit when the patient put on cervical hyperextension position after the operation, finally, decreases back to the preoperative level when the patient put on supine position after the operation.
出处
《中国医师进修杂志》
2010年第12期6-8,共3页
Chinese Journal of Postgraduates of Medicine
关键词
喉镜
眼内压
声带息肉切除术
Laryngoscopes
Intraocular pressure
Vocal cord polyp resection
