宫腔镜电切术治疗黏膜下子宫肌瘤围手术期血液流变学变化

摘要

Objective To investigate the blood rheology changes during hysteroscopic resection of submucous uterine ifbroids and provide a theoretical basis for clinical treatment. Methods From January to December, 2014, 45 cases with submucous uterine ifbroids were conducted hysteroscopic surgery in Dingxing hospital, before perfusion 10 min (T1), perfusion 30 min (T2), after surgery , blood rheology index level (T3) were detected. Results All cases were successfully conducted the operation, T3, T2 point blood rheology index of whole blood low-cut, middle cut high cut, low-cut reduction of whole blood, blood high shear reduced, plasma viscosity, etc., erythrocyte rigidity index, aggregation index, deformation index and maximum platelet aggregation compared with the index at T1, the difference was statistically signiifcant (P<0.05). T2 point hematocrit compared with T1 point indicator, the difference was statistically signiifcance (P<0.05). T3 point high shear whole blood, plasma viscosity, etc., hematocrit, erythrocyte rigidity index, maximum platelet aggregation compared with T2 each index point, the difference was statistically significant (P<0.05). Conclusion Perioperative blood rheology indicators for monitoring is necessary when longer operative time, more fluid absorption to reduce blood viscosity in patients with uterine fibroids after operation and protect red blood cells , reduce cardiovascular events and deep venous thrombosis.%目的：探讨宫腔镜电切术治疗黏膜下子宫肌瘤患者围手术期血液流变学变化情况，为临床治疗提供理论依据。方法选取定兴县医院2014年1月至12月45例黏膜下子宫肌瘤择期行宫腔镜电切术患者，分别检测灌注前10 min（T1）、灌注30 min（T2）、术毕（T3）时血流变学指标水平。结果45例手术均顺利完成，T3、T2时点血流变学指标全血低切、全血中切、全血高切、全血低切还原、全血高切还原、血浆黏度、红细胞刚性指数、聚集指数、变形指数及最大血小板聚集率与T1时点各指标相比较，差异有统计学意义（P＜0.05）；T2时点血细胞比容与T1时点指标比较，差异有统计学意义（P＜0.05）；T3时点全血高切、血浆黏度、血细胞比容、红细胞刚性指数、最大血小板聚集率与T2时点各指标比较，差异有统计学意义（P＜0.05）。结论宫腔镜电切术手术时间较长，灌注液吸收多时应进行围手术期血流变学指标监测，以降低黏膜下子宫肌瘤患者术后血液黏度，保护红细胞，降低心血管事件及深静脉血栓发生。