不同温度灌注液在宫腔镜子宫内膜电切术中的应用研究

Study on the application of perfusion fluid at different temperatures in hysteroscopic electric resection of endometrium

目的:探讨不同温度灌注液在宫腔镜子宫内膜电切术中的应用效果及护理方法。方法:将98例宫腔镜子宫内膜电切术患者随机分为A、B、C三组,A组灌注液为常温,B组灌注液温度为37℃,C组灌注液温度为4℃,观察并比较三组的灌注液用量、出血量、液体吸收量、电热损伤程度以及术前、术毕、术后1 h、术后3 h的静脉血生化指标。结果:4℃灌注液组与常温组相比,术后血清钠、钾、尿素氮、血浆渗透压、阴离子间隙等指标下降(P<0.05),能减少灌注液吸收、减轻电热损伤程度(P<0.01)、减少出血量(P<0.05),但可导致患者体温下降;而37℃灌注液与常温组相比,术中出血量无显著性差异(P>0.05),灌注液吸收量有极显著性差异(P<0.01)。结论:4℃灌注液替代常温灌注液应用于临床,可降低手术并发症的发生率,但要注意患者体温的护理。

Objective ： To explore the effect of perfusion fluid at different temperatures in hysteroscopic electric resection of endometrium and nursing methods. Methods ： Ninety eight patients who would have hysteroscopic electric resection of endometrium were randomly divided into three groups. Perfusion liquid at room temperature was used in group A; perfusion fluid at the temperature of 37 ℃ was used in group B and perfusion fluid at the temperature of 4 ℃ was used in group C. Observing and comparing the dosage of perfusion liquid, amount of bleeding, liquid absorption, electric injury as well as blood biochemical parameters in one hour before and after operation and 3 hours after operation among 3 groups. Results： Postoperative serum sodium, potassium, urea nitrogen, plasma osmolality, anion gap and other indicators were found de- clined in the comparison between group A and group C （ P 〈 0. 05 ）; perfusion fluid absorption and degree of heating injury were reduced （ P 〈 0. 01 ） , and the amount of bleeding were also reduced in group C （ P 〈 0.05） ; but the body temperature decreased. There was no significant difference in the comparison of bleeding volume in operation between group B and group A （ P 〉0. 05 ） , and perfusion fluid absorption had a very significant difference between the two groups （ P 〈0. 01 ）. Conclu- sion： Using perfusion fluid at the tenaperature of 4 ℃ instead of it at room temperature in clinic can reduce the incidence of surgical complications, but nursing care of body temperature of the patients should be emphasized.