膨宫介质5%葡萄糖在宫腔镜手术中对患者电解质的影响

Effect of 5% glucose on blood electrolyte during operative hysteroscopies

目的探讨宫腔镜手术中,5%葡萄糖作为膨宫介质时,因手术类型的不同,对患者电解质影响的差别。方法选择宫腔镜电切术患者91例,按手术类型的不同分为5组,于术前、术后采静脉血测定血清钠、氯、钾、糖及血浆渗透压等指标,并记录手术时间、膨宫介质吸收量,结果应用SPSS11.5统计软件进行分析。结果除术后血糖升高外,血钠、血氯、血钾及血渗透压均较术前下降,术后发生低钠血症者共21例,中重度低钠血症主要在TCRA、TCRE及TCRS术后发生,液体吸收差别提示TCRS、TCRE最多,TCRP吸收最少,相应的血生化变化在TCRS最大,TCRP最小。结论5%葡萄糖为膨宫介质在TCRS、TCRA、TCRE手术可能引起体液失衡,而TCRP相对则比较安全。

[Objective] To inquire the differences of changes in blood bio-chemistry during different kinds of operative hysteroscopies when we used 5% glucose as uterine distention media. [Methods] We enrolled ninety one patients in our study and divided them into five groups according to surgery procedure. Serum sodium, chlorine, potassium, glucose and plasm osmolality were measured before and after operation. In addition, we recorded operation time and deficit of uterine distention media. All data were analyzed by statistic system of SPSS 11.5. [Results] After operation, except serum glucose elevated, serum sodium, chlorine, potassium and plasm osmolality dropped down. Twenty-one eases were hyponatremia that mainly appeared medium and high level at procedures of TCRA, TCRE and TCRS. As for the deficit of uterine distention media, there were the grest in TCRS and TCRE, the little in TCRP. As for the variation of blood bio-ehemistry, there were the great in TCRS, the litde in TCRP. [Conclusions] Fluid overload may appear in procedures of TCRS, TCRA and TCRE when we used 5% glucose as uterine distention media. In contrast, the procedure of TCRP is safer.