Starks Victoria S, Gilliland Grant, Hise Joseph, Thacker Ike, Layton Kennith F
Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, Texas (Starks); and the Departments of Ophthalmology (Gilliland) and Radiology (Hise, Thacker, Layton), Baylor University Medical Center at Dallas.
Proc (Bayl Univ Med Cent). 2015 Apr;28(2):185-7. doi: 10.1080/08998280.2015.11929223.
We report the first utilization of intraoperative central venous pressure (CVP) monitoring in the resection of an orbital arteriovenous malformation. A 24-year-old woman with a history of a left orbital mass who had previously undergone resection of a cranio-orbital arteriovenous malformation presented with gradual recurrence in the left orbit. She visited the emergency department with sudden vision loss, which resolved over several hours. This transient vision loss was thought to be due to a steal phenomenon from the ophthalmic artery due to the residual vascular malformation. Further surgical resection was undertaken. A preoperative angiogram identified residual feeding vessels, and the larger vessels were embolized. At the start of the procedure, her CVP was elevated (29 mm Hg), as measured by a central venous line. The remaining feeding vessels were surgically ligated, and an intraoperative arteriogram confirmed their successful ablation. At the conclusion of the procedure, the CVP had decreased to 9 mm Hg.
我们报告了术中中心静脉压（CVP）监测在眼眶动静脉畸形切除术中的首次应用。一名24岁有左眼眶肿物病史的女性，曾接受颅眶动静脉畸形切除术，现左眼眶肿物逐渐复发。她因突发视力丧失就诊于急诊科，数小时后视力恢复。这种短暂性视力丧失被认为是由于残留血管畸形导致眼动脉盗血现象所致。遂进行进一步手术切除。术前血管造影确定了残留的供血血管，并对较大的血管进行了栓塞。手术开始时，通过中心静脉导管测量其中心静脉压升高（29 mmHg）。其余供血血管通过手术结扎，术中动脉造影证实成功切除。手术结束时，中心静脉压降至9 mmHg。
