本文選題：腎上腺素　切入點：視網(wǎng)膜脫離　出處：《吉林大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的：探討孔源性視網(wǎng)膜脫離(Rhegatogenous Retinal Detachment，RRD)鞏膜扣帶術(shù)后視網(wǎng)膜下液(Subretinal Fluid，SRF)的延遲吸收與血液中腎上腺素濃度的相關(guān)性，分析其原因，以期縮短視網(wǎng)膜脫離術(shù)后SRF的吸收時間。 方法：采用病例對照的方法，分析2009年-2011年吉林大學第二臨床學院眼底病二科行鞏膜扣帶術(shù)（包括環(huán)扎+冷凝、環(huán)扎+外墊壓+冷凝、外墊壓+冷凝，放液或不放液）的孔源性視網(wǎng)膜脫離患者44例（45只眼），男性21例（22只眼），女性23例（23只眼），年齡18-70歲，平均41.38±14.17歲。44例患者均為新鮮的孔源性視網(wǎng)膜脫離患者，所有患者術(shù)前視網(wǎng)膜脫離的范圍在1.9±0.8個象限。術(shù)后視網(wǎng)膜原裂孔封閉良好，未發(fā)現(xiàn)新裂孔，無明顯的PVR，術(shù)后眼壓穩(wěn)定在正常范圍內(nèi)，視網(wǎng)膜下液在術(shù)后1天-6個月吸收。上述病例均未實施第二次手術(shù)，術(shù)后視網(wǎng)膜下液逐漸減少，隨診1年，視網(wǎng)膜復位良好。按術(shù)后視網(wǎng)膜下液吸收的時間分為A組（≤3天）、 B組（3天到1個月）和C組（＞1個月）三組，其中B、C兩組視為“視網(wǎng)膜下液延遲吸收”組。三組患者均在術(shù)前1天及術(shù)后第1天清晨空腹肘靜脈采血，患者靜坐30min后前臂靜脈采血5mL,采集血液置于預冷肝素化的真空采血管中,樣本收集后30min內(nèi)在4度下離心3000r/min、30min后取上清，置-80度保存，待檢。標本采用長春比爾生物科技有限公司提供的腎上腺素ELISA檢測試劑盒，運用生物素雙抗體夾心酶聯(lián)免疫吸附法（ELISA）測定血清中的人腎上腺素（EPI）水平，，操作嚴格按試劑盒說明書進行。數(shù)據(jù)搜集完畢，SPSS16.0統(tǒng)計學軟件進行數(shù)據(jù)分析，比較三組患者術(shù)前1天及術(shù)后第1天、術(shù)后不同性別組以及每組術(shù)前1天與術(shù)后第1天的腎上腺素水平。 結(jié)果：（1）術(shù)前1天三組間血清腎上腺素水平比較：A組與B組, P=0.0130.05，差異有統(tǒng)計學意義；A組與C組, p=0.0050.05，差異有統(tǒng)計學意義；B組與C組,p=0.362＞0.05，差異無統(tǒng)計學意義。（2）術(shù)后第1天各組血清中腎上腺素值比較：A組與B組, p=0.0000.05,差異有統(tǒng)計學意義；A組與C組,p=0.000＜0.05,差異有統(tǒng)計學意義；B組與C組, p＞0.05,差異無統(tǒng)計學意義．（3）各組組內(nèi)術(shù)前1天與術(shù)后第1天腎上腺素水平比較：A組，p=0.0390.05,差異有統(tǒng)計學意義；B組，p0.05,差異無統(tǒng)計學意義；C組，p0.05,差異無統(tǒng)計學意義。（4）B組、C組中男、女術(shù)后腎上腺素比較， p=0.478＞0.05，差異無統(tǒng)計學意義。 結(jié)論：1.血清腎上腺素濃度與孔源性視網(wǎng)膜脫離術(shù)后視網(wǎng)膜下液的吸收具有相關(guān)性，腎上腺素水平高者視網(wǎng)膜下液吸收慢。2.特殊類型人群可根據(jù)術(shù)前血清腎上腺素濃度預測術(shù)后視網(wǎng)膜下液吸收的時間。
[Abstract]:Objective: to investigate the relationship between the delayed absorption of subretinal fluid (subretinal fluid) and the concentration of epinephrine in the blood after rhegmatogenous Retinal detachment (RRD) scleral buckling, and to analyze the causes, so as to shorten the time of SRF absorption after retinal detachment. Methods: from 2009 to 2011, scleral buckling was performed in the second Department of ophthalmopathy, Jilin University, from 2009 to 2011. There were 44 patients with rhegmatogenous retinal detachment (44 patients) with or without rhegmatogenous retinal detachment, including 21 males (22 eyes) and 23 females (23 eyes) aged 18-70 years (mean 41.38 鹵14.17 years), all of whom were fresh rhegmatogenous retinal detachment patients. The range of retinal detachment before operation was 1.9 鹵0.8 quadrant. After operation, the retinal original hole was well closed, no new hole was found, no significant PVR was found, and the intraocular pressure was stable in the normal range. The subretinal fluid was absorbed from 1 day to 6 months after operation. According to the time of subretinal fluid absorption, group A (鈮

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