不同膨宫压力对宫腔镜电切术中患者中心静脉压和血浆电解质变化的影响  

Influence of different distending pressure on central venous pressure and level of plasma electrolyte in patients undergoing hysteroscopic resection

作　　者：李江[1] 刘志强[2] 陈敏[1] 瞿煦临 

机构地区：[1]上海市浦东新区妇幼保健院麻醉科,上海201206 [2]上海市第一妇婴保健院麻醉科,上海201204

出　　处：《皖南医学院学报》2014年第6期546-548,共3页Journal of Wannan Medical College

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金资助(青年科技项目)(PW2013B-17)

摘　　要：目的:观察宫腔镜电切术中不同膨宫压力对患者中心静脉压力(CVP)和血浆电解质变化的影响,为避免TURS的发生提供依据。方法:根据术中压力不同将80例宫腔镜电切术按随机方式分为H组(膨宫压力150 mm Hg)和L组(膨宫压力100 mm Hg)两组,膨宫介质均为生理盐水,观察患者入室时(T0)、手术开始后10 min(T1)、术毕(T2)时间段患者CVP和各种电解质血生化指标。结果:两组间血浆电解质指标在监测的各时间点无统计学差异(P>0.05),CVP数值H组比L组上升更加显著,有明显的统计学差异(P<0.05)。结论:在宫腔镜电切术中CVP动态监测对TURS早期诊断有一定的临床意义,使用高膨宫压力的宫腔镜电切术,CVP的升高更为明显,术者须谨慎增加膨宫压,以避免TURS的发生。Objective：To observe the effects of different distending pressure on central venous pressure （ CVP） and plasma electrolyte level in women un-dergoing hysteroscopic resection for basis to prevent the incidence of transurethral resection syndrome （ TURS） .Methods：Eighty inpatients undergoing hyst-eroscopic resection were randomly allocated to two groups according to application of different distending pressure ,i.e.,Group H（150 mm Hg）and Group L（100 mm Hg） .The two groups were managed with physiological saline ,and observed concerning the variation of CVP and plasma electrolyte levels at en-tering the theater（T0）,10 min after the operation（T1） and operation completion（T2）.Results：Plasma electrolyte levels showed no difference between the two groups at the monitoring point（P〉0.05）,yet the CVP level was increased significantly in group H,which was statistically different（P 〈0.05）. Conclusion：Dynamic monitoring over the CVP variation in patients undergoing hysteroscopic resection may be significant for early estimation of TURS . When higher distending pressure is applied,elevated CVP is obvious,suggesting that great attentions should be paid in increasing the pressure to prevent incidence of TURS.

关 键 词：宫腔镜电切术 膨宫压力 中心静脉压力 血浆电解质 

分 类 号：R713[医药卫生—妇产科学]