全身麻醉非眼科手术患者术后发生眼损伤2例报告及文献复习

doi:10.13481/j.1671-587x.20190129

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (01): 156-159.doi: 10.13481/j.1671-587x.20190129

• 临床医学 • 上一篇

全身麻醉非眼科手术患者术后发生眼损伤2例报告及文献复习

张宁, 朴美花, 王美堃, 刘楠, 冯春生

吉林大学第一医院麻醉科, 吉林长春 130021

收稿日期:2018-06-15 发布日期:2019-01-28
通讯作者: 冯春生,教授,硕士研究生导师(Tel:0431-88782955,E-mail:fcs1971@hotmail.com) E-mail:fcs1971@hotmail.com
作者简介:张宁(1993-),女,山西省太原市人,在读医学硕士,主要从事麻醉药物对认知功能影响方面的研究。

Eye injury after non-ocular surgery in patients underwent general anesthesia: A report of 2 cases and literature review

ZHANG Ning, PIAO Meihua, WANG Meikun, LIU Nan, FENG Chunsheng

Department of Anesthesiology, First Hospital, Jilin University, Changchun 130021, China

Received:2018-06-15 Published:2019-01-28
Contact: 吉林省科技厅科技发展计划项目资助课题（20150101170JC） E-mail:fcs1971@hotmail.com

摘要/Abstract

摘要： 目的：探讨全身麻醉非眼科手术患者发生眼损伤的病因和危险因素，为其临床预防和诊治提供参考。方法：分析2例全身麻醉非眼科手术后发生眼损伤患者的临床资料，并复习相关文献。结果：1例青年女性患者于全身麻醉头低位下行"腹腔镜下全子宫切除术"，术中眼睑自然闭合，无眼保护措施，术后发生角膜擦伤，对症治疗后完全康复。1例老年男性患者于全身麻醉俯卧位下行"颈椎后路椎管扩大成形术"，术后发生缺血性视神经病变（ION），对症治疗后视力部分恢复。结论：角膜擦伤是全身麻醉相关的最常见的眼科并发症，患者大多预后良好。术后视力丧失（POVL）是最严重的并发症，其具体发病原因及机制尚未完全阐明，缺乏有效治疗手段，重在预防。

关键词: 全身麻醉, 眼损伤, 角膜擦伤, 术后视力丧失, 缺血性视神经病变, 视网膜中央动脉阻塞

Abstract: Objective: To study the pathogenesis and the risk factors of eye injury after non-ocular surgery in the patients underwent general anesthesia, and to provide the reference for its prevention,diagnosis and treatment.Methods: The clinical materials of two patients with eye injury after non-ocular surgery underwent general anesthesia were analyzed and the related literatures were reviewed.Results: A young woman patient underwent laparoscopic hysterectomy with general anesthesia while positioned Trendelenburg,the eyes were being closed naturally without protection,and corneal abrasion of both eyes occurred after operation. The lesion had completely resolved with no sequelae after treatment.An old man underwent cervical posterior laminoplasty with general anesthesia in prone position developed ischemic optic neuropathy(ION) after operation. The vision of the patients partly recovered after symptomatic treatment.Conclusion: Corneal abrasion is the most frequent ophthalmologic complication during general anesthesia,most of the patients have good prognosis. Postoperative visual loss(POVL) is the most severe ophthalmologic complication without effective treatment available,the delicate reasons and mechanisms are not totally clear,prevention outweighs treatment.

Key words: general anesthesia, eye injury, corneal abrasion, postoperative visual loss, ischemic optic neuropathy, central retinal artery occlusion

中图分类号:

R614.2

张宁, 朴美花, 王美堃, 刘楠, 冯春生. 全身麻醉非眼科手术患者术后发生眼损伤2例报告及文献复习[J]. 吉林大学学报(医学版), 2019, 45(01): 156-159.

ZHANG Ning, PIAO Meihua, WANG Meikun, LIU Nan, FENG Chunsheng. Eye injury after non-ocular surgery in patients underwent general anesthesia: A report of 2 cases and literature review[J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 156-159.

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全身麻醉非眼科手术患者术后发生眼损伤2例报告及文献复习

Eye injury after non-ocular surgery in patients underwent general anesthesia: A report of 2 cases and literature review

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