[1]张晓伟,陈 明,田谋利,等.术中体位变化和气腹对机器人辅助腹腔镜根治性膀胱切除患者眼压的影响[J].医学信息,2020,33(14):113-116.[doi:10.3969/j.issn.1006-1959.2020.14.034]
　ZHANG Xiao-wei,CHEN Ming,TIAN Mou-li,et al.Effects of Intraoperative Posture Changes and Pneumoperitoneum on Intraocular Pressure in Patients with Robot-assisted Laparoscopic Radical Cystectomy[J].Medical Information,2020,33(14):113-116.[doi:10.3969/j.issn.1006-1959.2020.14.034]
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术中体位变化和气腹对机器人辅助腹腔镜根治性膀胱切除患者眼压的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年14期
页码:
113-116
栏目:
临床研究
出版日期:
2020-07-15

文章信息/Info

Title:
Effects of Intraoperative Posture Changes and Pneumoperitoneum on Intraocular Pressure in Patients with Robot-assisted Laparoscopic Radical Cystectomy
文章编号:
1006-1959（2020）14-0113-04
作者:
张晓伟; 陈 明; 田谋利; 等
（1.同济大学附属上海市杨浦区中心医院麻醉科，上海 200000；（2.海军军医大学附属长征医院泌尿外科，上海 200003；（3.海军军医大学附属长征医院麻醉科，上海 200003）
Author(s):
ZHANG Xiao-wei; CHEN Ming; TIAN Mou-li; et al
(1.Department of Anesthesiology,Shanghai Yangpu District Central Hospital,Tongji University,Shanghai 200000,China;(2.Department of Urology,Changzheng Hospital,The Second Military Medical University,Shanghai 200003,China;(3.Department of Anesthesiology,C
关键词:
膀胱癌; 眼压; 机器人; 腹腔镜根治性膀胱切除术; 体位; 气腹
Keywords:
Bladder cancer; Intraocular pressure; Robot; Laparoscopic radical cystectomy; Posture;  Pneumoperitoneum
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2020.14.034
文献标志码:
A
摘要:
目的 探讨术中体位变化和气腹对机器人辅助腹腔镜根治性膀胱切除术患者眼压的影响。方法 回顾性分析2019年1~12月海军军医大学附属长征医院行机器人辅助腹腔镜根治性膀胱切除的56例膀胱癌患者的临床资料，根据尿流改道方式的不同分为为造瘘组34例，ECUD组20例，ICUD组2例，比较三组一般资料、不同时间点眼压及不良反应情况。结果 56例患者均顺利完成手术，三组体重、BMI比较，差异无统计学意义（P＞0.05）。三组年龄、麻醉时间和手术时间比较，差异有统计学意义（P＜0.05）。与T1时眼压比较，三组T2时点眼压均下降，下降值分别为5.07 mmHg、5.17 mmHg、4.43 mmHg，差异有统计学意义（P＜0.05），T3时点眼压升高，升高值分别为8.15 mmHg、6.71 mmHg、7.32 mmHg，差异有统计学意义（P＜0.05），T4时点眼压进一步升高，升高值分别为10.86 mmHg、10.20 mmHg、10.60 mmHg，差异有统计学意义（P＜0.05）；造瘘组和ECUD组T5时点眼压分别降至18.86 mmHg和18.39 mmHg，与T1时点比较，差异无统计学意义（P＞0.05）；ECUD组T6时点眼压较T1时点再次升高，差异有统计学意义（P＜0.05）。三组T7时点眼压均高于T1时点，但差异无统计学意义（P＞0.05）。有25例术中出现球结膜水肿，其中造瘘组12例，ECUD组11例，ICUD组2例；术后1周随访，球结膜水肿均已消退。结论 RARC不同尿流改道方式术中患者眼压随手术时间延长逐渐增加，术中通过药物干预可以缓解眼压升高，但无法消除气腹和体位改变对眼压的影响。
Abstract:
Objective To investigate the effects of intraoperative posture changes and pneumoperitoneum on intraocular pressure in patients with robot-assisted laparoscopic radical cystectomy.Methods The clinical data of 56 patients with bladder cancer who underwent robot-assisted laparoscopic cystectomy in Changzheng Hospital,The Second Military Medical University from January to December 2019 were retrospectively analyzed. According to the different ways of urinary diversion, 34 patients were divided into fistula group,20 cases in the ECUD group and 2 cases in the ICUD group, comparing the general information of three groups, intraocular pressure and adverse reactions at different time points.Results All 56 patients completed the operation successfully. There was no significant difference in weight and BMI among the three groups (P>0.05).The age, anesthesia time and operation time of the three groups were statistically significant (P<0.05). Compared with the intraocular pressure at T1, the intraocular pressure at the T2 point in all three groups decreased, and the decreasing values were 5.07 mmHg,5.17 mmHg, and 4.43 mmHg, respectively,the difference was statistically significant (P<0.05). The intraocular pressure at T3 point increased, and the increased value the differences were 8.15 mmHg, 6.71 mmHg, 7.32 mmHg, the difference was statistically significant (P<0.05), the intraocular pressure further increased at T4 point, the increase values were 10.86 mmHg, 10.20 mmHg, 10.60 mmHg, respectively, the difference was statistically significant (P<0.05);In the fistula group and the ECUD group, the intraocular pressure decreased to 18.86 mmHg and 18.39 mmHg at T5, respectively. Compared with the T1 time, the difference was not statistically significant (P>0.05).In the ECUD group, the intraocular pressure at T6 was higher than that at T1,the difference was statistically significant (P<0.05).The intraocular pressure at T7 was higher than that at T1 in the three groups, but the difference was not statistically significant (P>0.05). There were 25 cases of bulbar conjunctival edema during operation, including 12 cases in the fistula group, 11 cases in the ECUD group, and 2 cases in the ICUD group; follow-up 1 week after surgery, the bulbar conjunctival edema had all resolved.Conclusion The intraocular pressure of RARC patients with different urinary diversion methods increased gradually with the extension of the operation time. Intraoperative intraoperative drug intervention can alleviate the increase of intraocular pressure, but it cannot eliminate the effect of pneumoperitoneum and posture changes on intraocular pressure.

参考文献/References:

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更新日期/Last Update: 1900-01-01