末梢血糖监测对预防宫腔镜电切术过度水化综合征的临床意义

Clinical importance of monitoring finger blood glucose during hysteroscopic surgery

目的研究宫腔镜电切术中末梢血糖的监测对预防宫腔镜电切术过度水化综合征的临床意义。方法选择40例子宫良性病变患者行宫腔镜电切术,以5%葡萄糖溶液作为膨宫介质,于手术开始时、手术30、60min、术毕行末梢血糖检测并分别采静脉血测定血清钠、血糖。结果血糖于手术30和60min与术前值比较均显著增高(P<0.05)。而且60与30min比较血糖有明显上升(P<0.05)。血钠30min与术前比较差异无显著性(P>0.05),但60min与术前比较血钠有显著降低(P<0.05)。手术时间>60min者术后血清钠较术前明显下降(P<0.05),血糖于术毕明显升高(P<0.05);血钠降低与血糖升高之间有相关性(P<0.05)。结论宫腔镜电切术中灌流液的吸收可引起一过性血清钠、血糖的改变;术中监测末梢血糖的变化,可有效预防电切综合征发生。

[Objective] To study the effect of irrigating fluid absorption on the changes in finger blood glucose during hysteroscopic infusion surgery and the relationships between the transient hyperglycaemia and hyponatremia. [Method] Forty patients with benign uterine conditions who underwent hysteroscopic resection were enrolled in our study. 5% dextrose was used as irrigating fluid. Finger blood glucose, serum sodium, and glucose were measured before, 30, 60 minutes, and at the end of operation respectively. [Results] The serum glucose level and finger blood glucose increased markedly during operation as compared with that before operation （P 〈0.05）. There was a significant higher blood glucose level at 60 min than that 30 min during operation （P 〈0.05）. Serum sodium was not significantly changed at 30 min compared with that before operation （P 〉0.05）. There was a significant lower sodium level after operation than that before when operating time more than 60 minutes （P 〈0.05）. The fall in serum sodium concentration was correlated with the elevation of plasma glucose （P 〉0.05） [Conclusion] There are transient changes in serum sodium, plasma glucose and finger blood glucose due to the absorption of irrigating fluid during hysteroscopic resection. Finger blood sugar monitoring is the fast and simple method to prevent transurethral resection of syndrome effectively.