子宫切除术中单极和双极能量效果的比较

О.V. Golyanovskiy, O.A. Voloshin, A. Novosad
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摘要

目的:评价单极或双极宫腔镜手术患者术后并发症、手术干预时间和住院时间。材料和方法。80例接受宫腔镜手术的妇科病人被分为两组,每组40名妇女。I(主要)组患者宫腔镜手术采用双极电极,II(比较)组患者采用单极电极。对手术并发症进行了记录——出血、穿孔、积液过多和低钠血症。手术时间和住院时间也被考虑在内。两组患者的特征、超声表现、术前、术后血清钠水平、子宫穿孔、术中出血等差异均无统计学意义。II组患者的体液负荷明显高于对照组(p<0.03)。II组术后低钠血症发生率也显著高于对照组(p<0.05)。I组患者平均手术时间明显短于II组(p=0.01),双极能量组患者住院时间明显短于单极能量组(p=0.04)。结论。使用双极电极的子宫切除术伴随着低钠血症病例的显著减少,手术干预时间缩短,妇科患者术后住院时间缩短。因此,与使用单极电极相比,该方法安全有效。
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Comparative characteristics of the effect of mono and bipolar energy during hysteroresectoscopy
The objective: to evaluate of postoperative complications, duration of surgical intervention and hospital stay of patients after hysteroscopic surgery using monopolar or bipolar electrodes.Materials and methods. Eighty gynecological patients who had hysteroscopic surgery were divided into two groups of 40 women each. Patients of the I (main) group had hysteroscopic procedures using a bipolar electrode, the persons in the II (comparison) group – a monopolar electrode. The registration of operative complications was carried out – bleeding, perforation, excess fluid and hyponatremia. The time of operation and stay in a gynecological hospital were also taken into account.Results. There were no statistically significant differences between the two groups regarding patient’s characteristics, ultrasound findings, serum sodium levels before and after surgery, uterine perforation, and intraoperative bleeding. Fluid overload was significantly higher in patients of the II group (p<0.03). Postoperative hyponatremia was also significantly pronounced in the II group (p<0.05). The average operation time was significantly shorter in women of the I group compared to the II group (p=0.01), and the hospital stay was significantly shorter for patients after hysteroscopic intervention using bipolar energy compared to the group in which monopolar energy was used (p=0.04). Conclusions. Hysteroresectoscopy with the use of bipolar electrodes is accompanied by a significant decrease in cases of hyponatremia, reduction of the duration of surgical intervention and the stay of gynecological patients in the hospital after surgery. Therefore, this method is safe and effective compared to the use of monopolar electrodes.
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