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目的:探讨宫腹腔镜联合手术治疗不孕症的安全性及手术时间与膨宫液吸收量之间的相关性。方法:观察40例不孕症患者宫腹腔镜联合手术的总体情况及术后患者血液生化指标的变化,比较术中回收的经宫颈体外流出的膨宫液量与经由输卵管途径进入腹腔的液体量,探讨宫腔镜手术时间与膨宫液吸收入血循环的量之间的相关性。结果:手术前后40例患者的血生化指标在临床正常参考值范围内变动;手术麻醉时间40～180 min;二氧化碳气腹时间27～155 min;宫腔镜手术时间1～30 min;膨宫液总用量80～8 000 ml,吸收入血量10～1 080 ml,膨宫液吸收入血量与麻醉时间、气腹时间、膨宫时间呈正相关;40例患者无一例发生体液超负荷及稀释性低钠血症。结论:宫腹腔镜联合手术治疗不孕症相对安全,术中可有效估计膨宫介质的吸收入血量,减少体液超负荷及稀释性低钠血症的发生,值得临床推广。
Objective: To investigate the safety of laparoscopic combined surgery in the treatment of infertility and the correlation between operation time and the amount of fluid absorption. Methods: The general conditions of hysteroscopy combined with laparoscopy in 40 cases of infertility patients and changes of blood biochemical parameters after operation were observed. The volume of fluid discharged from the cervix during operation and the amount of fluid entering the abdominal cavity via the fallopian tube were compared , To explore the correlation between hysteroscopic surgery time and the amount of uterine fluid absorption into the blood circulation. Results: The blood biochemical parameters of 40 patients before and after surgery varied within the normal reference range of the clinical data. The anesthesia time was 40 to 180 minutes, the carbon dioxide pneumoperitoneum time was 27 to 155 minutes, the hysteroscopy was performed for 1 to 30 minutes, The total amount of 80 ~ 8 000 ml, absorbed into the blood volume of 10 ~ 1 080 ml, uterine fluid intake into the blood volume and anesthesia time, pneumoperitoneum time, swelling time was positively correlated; 40 cases of patients without body fluid overload and dilution Hyponatremia. Conclusion: Hysteroscopy combined with surgical treatment of infertility is relatively safe, intraoperative can effectively estimate the amount of fluid absorption into the uterine barrier to reduce the incidence of body fluid overload and dilutional hyponatremia, worthy of clinical promotion.