不同膨宫介质对宫腔镜电切手术患者血浆电解质、渗透压及中心静脉压等指标的影响分析  

Effects of different uterine distention mediators on plasma electrolytes,osmotic pressure and central venous pressure in patients undergoing hysteroscopic resection

作　　者：徐丽[1] 王一男[1] 曹秀玲[1] 李晓光[1] XU Li;WANG Yinan;CAO Xiuling(Department of Anesthesiology,Beijing Maternity Hospital Affiliated to Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院麻醉科,北京市100006

出　　处：《河北医药》2019年第9期1363-1365,1369,共4页Hebei Medical Journal

摘　　要：目的观察不同膨宫介质对宫腔镜电切手术患者血浆电解质、渗透血压及中心静脉压等指标影响。方法选取2013年2月至2017年12月收治的行宫腔镜电切手术治疗患者74例,按随机数字表法分为葡萄糖组(n=39)与0.9%氯化钠溶液组(n=35),2组患者膨宫压力均为100 mm Hg,其中葡萄糖组患者膨宫介质为5%葡萄糖注射液,0.9%氯化钠溶液组患者膨宫介质为0.9%氯化钠溶液,分别于术前、术毕、术后3 h抽取2组患者静脉血,监测其血浆电解质、渗透压及中心静脉压等指标变化。结果术前,2组患者Na^+、K^+、Cl^-、POP、CVP、BUN、SCr、GLU、CO_2-CP指标比较差异无统计学意义(P>0.05),术毕、术后3 h 2组患者Na^+、K^+、Cl^-、POP、BUN、SCr、CO_2-CP指标较术前均明显下降(P<0.05),其中术毕葡萄糖组患者Na^+、K^+指标降至最低点,0.9%氯化钠溶液组患者POP指标降低最低点,术后3 h 0.9%氯化钠溶液组患者Na^+、K^+指标降至最低点;术毕、术后3 h 2组患者CVP、GLU指标较术前明显上升(P<0.05),其中术毕葡萄糖组患者GLU指标升至最高点,术后3 h 0.9%氯化钠溶液组患者GLU指标升至最高点。结论针对行宫腔镜电切手术治疗患者实施0.9%氯化钠溶液介质较葡萄糖介质患者的临床效果更佳,更有利维持患者生化指标稳定性,降低术后电切综合征发生率,同时适当控制膨宫压力有利于监测中心静脉压提示电切综合征发生。Objective To observe the effects of different uterine distention mediators on plasma electrolytes, osmotic pressure and central venous pressure in patients who underwent hysteroscopic resection.Methods Seventy-four patients who underwent hysteroscopic resection in our hospital from February 2013 to December 2017 were randomly divided into glucose group(n=39) and saline group(n=35) according to random number table. The uterine pressure of the patients in both groups was 100 mmHg. The uterine distention mediator of the patients in both groups was 5% glucose injection and 9% sodium chloride solution, respectively. The venous blood of the patients in both groups was collected before operation, at the end of operation and at 3 h after operation to monitor the changes of plasma electrolytes, osmotic pressure,and central venous pressure.Results Before the operation,there were no significant differences in the levels of Na^+, K^+, Cl^-, POP, CVP, BUN, SCr,GLU and CO2CP between the two groups(P>0.05). The levels of Na^+, K^+, Cl^-, POP, BUN, SCr,and CO2CP at the end of operation and at 3 h after operation in both group were significantly decreased(P<0.05).The levels Na+and K+ of the patients at the end of operation in glucose group, the Na^+and K^+ of the patients at 3 h after operation in saline group and the POP of the patients in saline group were decreased to the lowest point, respectively. Moreover, the levels of CVP and GLU of the patients at the end of operation and at 3 h after operation in both groups were increased significantly(P<0.05). And the levels of GLU of patients at the end of operation in glucose group and those of the patients at 3 h after operation in saline group were increased to the highst point, respectively.Conclusion Normal saline medium is more effective than glucose medium in patients who underwent hysteroscopic resection. It is more beneficial to maintain the stability of biochemical indicators, reduce the incidence of postoperative electrocution syndrome, control the pressure of uterine dist

关 键 词：宫腔镜电切手术 膨宫介质 血浆电解质 渗透压 中心静脉压 

分 类 号：R614.2[医药卫生—麻醉学]