改良侧卧折刀位对后腹腔镜手术患者术中眼压增高的影响

摘要

目的 探讨改良侧卧折刀位对患者术中眼压的影响.方法 将48例后腹腔镜手术患者随机分为对照组和观察组各24例,对照组采用将床头摇低15°角,床尾摇低30°角的传统折刀位;观察组为先摆放对照组的传统侧卧折刀位,在此基础上整体调整手术床头高脚低15°角.监测摆放体位前(To)、摆放体位后10 min (T1)、建立气腹后30 min (T2)、放气后10 min(T3)、术毕10 min (T4)的眼压指标.结果 观察组手术全程眼压较对照组稳定;对照组于手术体位后5 min眼压开始上升,与观察组摆手术位后10 min、30 min、术毕10 min比较,差异有统计学意义(P＜0.05或P＜0.01).结论 经后腹腔镜手术的患者采取改良侧卧折刀位可以有效地降低手术体位导致的眼压的变化,从而减轻眼球结膜的水肿,降低患者术后视力损害的风险.%Objective To investigate the effect of modified lateral clasp-knife position on intraocular pressure of patients.Methods A total of 48 patients with posterior laparoscopic surgery were randomly divided into the control group and the observation group,24 cases in each group.The control group was conducted with the traditional folding position that shook the head of the bed with a low angle of 15 degrees,and the end of the bed with 30 degrees.The observation group was treated with modified lateral clasp-knife position that shook the high foot of the surgical bed with a angle of 15 degrees.The intraocular pressure indexes at the time points of before monitoring of putting position (T0),10 min after putting position (T1),30 min after pneumoperitoneum (T2),10 min after removing pneumoperitoneum (T3) and 10 min (T4) after operation were monitored.Results The intraocular pressure of the observation group was more stable than the control group,and the intraocular pressure 5 min after putting position increased in the control group,and there werc significant differences at T1,T2,T4 between two groups (P ＜ 0.05 or P ＜ 0.01).Conclusion Modified lateral clasp-knife position can effectively reduce the change of intraocular pressure caused by the surgical position,reduce the edema of the conjunctiva and reduce the risk of postoperative visual impairment.