目的 观察不同角度头高脚低俯卧位病人在俯卧位前后眼压的变化,研究不同倾斜角度对俯卧位病人眼压的影响,为临床寻找一种简单有效的降低俯卧位手术病人眼压的方法,以减少术后视力障碍的风险.方法 选择后路腰椎手术病人,随机分为3组,0°组手术床水平位,2.5°组手术床头高脚低倾斜 2.5°,5°组手术床头高脚低倾斜5°;分别于手术前术后测量各组病人眼压,统计各组病人的术前气道压、术中失血量、术中输液量、尿量以及病人俯卧位持续时间.结果 各组病人术前气道压、术中输液量、术中出血量、尿量、俯卧位持续时间差异均无统计学意义.术前眼压值3组病人间差异无统计学意义(P>0.05);各组病人术后眼压较术前均有升高,差异有统计学意义;术后3组病人眼压的差异有统计学意义,组间两两比较0°组与2.5°组、2.5°组与5°组间差异无统计学意义,0°组与5°组差异有统计学意义.结论 倾斜5°的头高脚低俯卧位可在不影响手术操作的情况下,降低后路腰椎手术病人眼压,以避免术后视力损害风险.%Objective To observe the change of intraocular pressure occurring among patients undergoing posterior lumbar vertebra operation in prone position, to explore the effects of head-up tilt prone position with different degrees on intraocular pressure and to find out a simple and effective method to lower the risk of postoperative vision loss.Methods Patients undergoing elective lumbar vertebra internal fixations Were randomly divided into three groups, 0° group, 2.5° group and 5° group with head-up tilt degrees of 0°,2.5° and 5.0° in each group respectively.The intraocular pressure of both eyes in each patient was measured both before and immediately after operations.Results No significant differences of intraocular pressure were found in all three groups before operation (P＞0.05).There werr also no significant differences of intraocular pressure between patients in 0° group and 2.5° group and patients between 2.5° group and 5° group after operation (P＞0.05).Apparently significant difference of intraocular pressure between patients in 0° group and 5° group after operation was observed (P＜0.01).Conclusion The degrees of bead-up tilt prone position correlates negatively with intraocular pressure after operation.The higher the tilting degree, the lower the intraocular pressure.5°head-up tilt prone position is a both simple and effective way to lower the intaocular pressure in patients undergoing posterior lumbar vertebra operation.
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