单双极电极系统宫腔镜手术对患者电解质影响的比较

Different Effect on Blood Electrolyte between Monopolar and Bipolar Electrode System during Operative Hysteroscopies

【目的】探讨宫腔镜手术中,因电极系统的不同,对患者电解质影响的差别。【方法】选择宫腔镜电切术患者104例,按照手术中应用电极系统的不同将其分为两组:单极电切组50例,双极电切组54例。于术前、术后即刻测定血钠、氯、钾、糖及血浆渗透压等指标,并记录手术时间、膨宫液吸收量。【结果】在单极与双极电切组中,手术时间、膨宫液吸收量和血糖、血钠、血氯变化值分别是:(16±7)min与(14±4)min,495.0mL与300.0mL,(6±9)mmol/L与(1.5±1.0)mmol/L,(-3±5)mmol/L与(-1.5±1.5)mmol/L,(-1±3)mmol/L与(0.5±1.6)mmol/L。与单极电切术比较,双极电切术手术时间短,膨宫液吸收量少,对患者生化的影响更小。【结论】双极电极系统在维持电解质平衡方面更具优越性。

[Objective] To inquire the differences in variations of blood electrolyte in operative hystemscopies with different kinds of electrode system. [ Method] A total of 104 patients were enrolled, including 50 cases of monopolar resectoseopic surgery and 54 cases of bipolar resectoseopic surgery, which was divided according to the difference of electrode system. Serum sodium, chlorine, potassium, glucose and plasm osmolality were measured before and after operation. The operation time and deficit of uterine distention media were recorded. [ Result] In the monopolar and bipolar group, the operation time, absorption volume, and variations of serum glucose, sodium, chlorine were （16±7） min vs. （14±4） min, 495.0 mL vs. 300.0 mL, （6±9） mmol/L vs. （1.5±1.0） retool/L, （-3±5） mmol/L vs. （-1.5±1.5） mmol/L, （-1±3） mmol/L vs. （0.5±1.6） mmol/L, respectively. Compared with the monopolar electrode system, bipolar electrode system was associated with a reduction in operation time and absorption volume of uterine distention medium and makes less influence on blood biochemistry. [Conclusion] Bipoiar electrode system is superior to keep the balance of blood electrolyte.