目的 探讨高频彩色多普勒超声在评价球外反搏治疗循环障碍性眼病中的应用价值.方法 对21例缺血性视神经病变患者行球外反搏治疗,采用高频超声分别于治疗前及治疗后1、5、15 min检测患者视网膜中央动脉及睫状后短动脉.将超声探头轻置于患者眼睑处作眼球横切和纵切扫查,测量视网膜中央动脉时,将取样容积置于距眼球壁后极约5 mm的视神经暗区内,寻找迎向探头的红色血流柱,其旁有蓝色血流柱(视网膜中央静脉)相伴行;测量睫状后短动脉时,将取样容积置于距眼球壁后极约5 mm的视神经暗区旁,寻找迎向探头的红色血流柱.检测视网膜中央动脉及睫状后短动脉的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)及阻力指数(RI),并对治疗前后血流参数行统计学分析. 结果球外反搏治疗后患者视网膜中央动脉及睫状后短动脉PSV、EDV即刻明显升高(P＜0.05),其后逐渐降低,15 min时基本恢复至反搏前;阻力指数治疗前后差异无统计学意义.结论 高频彩色多普勒超声可无创监测球外反搏治疗前后眼底血管血流速度变化,可作为球外反搏疗效评估的依据.%Objective To evaluate the influence of extraocular counterpulsation on ocular fundus blood vessels using high-frequency color Doppler ultrasonography. Methods Twenty-one patients with ischemic optic neuropathy were treated with extraocular counterpulsation. During treatment, the Doppler spectra were detected with high-frequency color Doppler ultrasonography. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance retinal index (RI) of central retinal artery and posterior ciliary artery were measured instantly before treatment and 1 min,5 min and 15 min after treatment. Results The instant PSV and EDV of central retinal artery and posterior ciliary artery were significantly increased (P＜0.05) after treatment, then decreased gradually. Fifteen min after treatment ,they returned to the level before treatment. Conclusions We can observe the changes of ocular fundus blood vessels noninvasively on high-frequency color Doppler ultrasonography. The method may be regarded as one of the basis for evaluating the effect of extraocular counterpulsation.
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