内腔镜手术监测仪预防宫腔镜手术并发症的临床效果  

The clinical efficacy of endoscopic operation monitor to prevent complications of the hysteroscope operation

作　　者：胡雪梅[1] 张继学[2] 魏风云 王泓 王玉龙 张龙[1] 陈德新[1] 王志平[1] 郭红宇[1] HU Xuemei;ZHANG Jixue;WEI Fengyun;WANG Hong;WANG Yulong;ZHANG Long;CHEN Dexin;WANG Zhiping;GUO Hongyu(The Second Hospital of Lanzhou University, Gansu Province, 730000;Baiyin Maternal and Child Health Care Hospital, Gansu Province)

机构地区：[1]兰州大学第二医院,730000 [2]甘肃省白银市妇幼保健院

出　　处：《中国计划生育学杂志》2020年第5期693-698,共6页Chinese Journal of Family Planning

基　　金：甘肃省省级引导科技创新发展专项资金项目(纵20180061)。

摘　　要：目的:利用内腔镜监测仪监测宫腔镜电切术中冲洗液吸收量和出血量,为实现精准监测和预防并发症发生提供技术支撑。方法:选择行子宫内膜电切术30例为内膜电切组,行肌瘤电切术30例为肌瘤电切组,利用内腔镜监测仪监测冲洗液吸收量、手术时间和出血量;并对患者术前和术后1h血清电解质进行监测。结果:内膜电切组冲洗液吸收量为300.5±80.6ml,出血量34.4±9.9ml,手术时间34.7±8.7min;肌瘤电切组冲洗液吸收量315.2±113.4ml,出血量101.4±24.0ml,手术时间41.1±7.5min。两组无手术并发症发生。内膜电切组及肌瘤电切组手术时间分别与灌流液总量、冲洗液吸收量、出血量均呈正相关,出血量与膨宫压、宫腔深度、内膜厚度呈正相关、吸收量与膨宫压、宫腔深度、肌瘤大小、出血量呈正相关(均P<0.01)。两组术后患者K^+、Na^+、Ca2^+、Cl-、CO2-CP浓度均低于术前(P<0.01)。结论:内腔镜手术监测仪可实时准确监测术中冲洗液吸收量、出血量,对精准监测和预防经尿道电切综合征发生有一定辅助价值。Objective:To observe the amount of absorbed and bleeding volume during hysteroscopic resection by endoscopic monitor,and to provide skill for accurate monitoring and preventing the occurrence of complications.Methods:30 patients with transcervical resection of endometrium(TCRE)were selected in group A,30 patients with transcervical resection of myoma(TCRM)were selected in group B.The operative time,the absorbed volume of irrigation liquid and bleeding volume were supervised by endoscopic monitor.Electrolytes of patients before surgery and one hour after surgery were detected.Results:The absorbed volume of irrigation liquid,volume of blood loss,the average operation time of patients in Group A were 300.5±80.6 ml,34.4±9.9 ml,and 34.7±8.7 min,respectively,and those of patients in group B were 315.2±113.4 ml,101.4±24.0 ml,and 41.1±7.5 min respectively.There were no significant different in the complications rates of patients between the two groups.The operation time of patients in group A and group B was positively correlated with the total volume of perfusion fluid,the absorbed volume of irrigation liquid,or the amount of blood loss.And the amount of blood loss of patients in group A and group B was positively correlated with the uterine pressure,the uterine cavity depth,the endometrial thickness of patients.And the absorbed volume of irrigation liquid of patients in group A and group B was positively correlated with the uterine pressure,the uterine cavity depth uterine fibroids size,or the amount of blood loss(all P<0.01).The concentrations of K+,Na+,Ca2+,Cl-and CO2-CP of postoperative patients in the two groups had all significant lower than those before surgery(P<0.01).Conclusion:The endoscopic monitors can real-time and accurate monitoring the amount of absorbed and bleeding volume during surgery,which is valuable for accurate monitoring and preventing occurrence of transurethral resection of the prostate syndrome.

关 键 词：子宫内膜电切术 宫腔镜肌瘤电切术 宫腔镜手术监测仪 冲洗液吸收量 出血量:手术时间 

分 类 号：R73[医药卫生—肿瘤]