摘要
目的讨论宫腔镜电切术中并发急性肺水肿的潜在因素、临床特点及防治措施。方法对2006年1月至2008年12月中宫腔镜电切术中发生急性肺水肿的病例进行临床分析。结果252例宫腔镜电切术中有3例发生急性肺水肿,占1.19%,且均为全身麻醉患者。宫腔镜子宫肌瘤电切术(宫腹腔镜联合术)2例,其中多发性子宫肌瘤1例,黏膜下子宫肌瘤合并陈旧性子宫穿孔并大网膜嵌顿1例;宫腔粘连分离术1例,重度粘连,以肌性粘连为主,创面大。3例患者经利尿脱水、纠正低钠血症、强心等治疗后治愈。结论急性肺水肿的发生与复杂的宫腔内操作有关。早期诊断治疗预后好。控制宫腔灌流压力及手术时间,减少灌流液的吸收,以及术中严密监测是预防其发生的关键。
Objective To investigate the cause,clinical characteristics,treatment and prevention of acute pulmonary edema during the hysteroscopic electroresection.Methods Total 3cases of acute pulmonary edema during the hysteroscopic electroresection,which took place from January 2006 to December 2008,were clinical analyzed.Results Total 3 cases of acute pulmonary edema occurred during the hysteroscopic electroresection 252 cases.The morbidity was 1.19%. They were general anaesthesia. 2 cases were transcervical resection of myoma （TCRM）, including one multiple hysteromyoma, one uter-ine perforation complicated with incarceration of omentum and submucosal myoma. Another one case was transcervical resection of uterine adhesion （TCRA）, with the extensive myogenic adhesion, many blood vessel were exposured. These cases were cured by diuretic agent, saline infusion, and cardiotonic. Conclusion Acute pulmonary edema is induced by the complex procedures intra - uterine. The earlier diagnosis is helpful for favorable prognosis. It＇ s the key methods to prevent acute pulmonary edema by controlling operating time, the pressure in the uterine cavity and the absorption of irrigating flow.
出处
《医药论坛杂志》
2009年第22期1-2,6,共3页
Journal of Medical Forum
关键词
宫腔镜检查
电外科手术
手术并发症
急性肺水肿
Hysterescopy
Electrosurgery
Intraoperative complications
Pulmonary edema
