CAJ | 학술논문

目的探讨宫腔镜手术患者发生空气栓子的诱因.方法择期椎管内麻醉下行宫腔镜手术患者35例,ASA分级Ⅰ或Ⅱ级,年龄22 ～ 59岁,体重指数18～25 kg/m2.术中用单极或双极电刀行电切和电凝止血,采用logic vivid Ⅰ彩色多普勒超声成像仪监测患者髂总静脉和上腔、下腔静脉及心脏空气栓子的发生情况.根据术中是否发生空气栓子分为空气栓子组和无空气栓子组,分析发生空气栓子的可能因素.结果 15例患者发生了空气栓子,发生率为43％,发生时间为膨宫液灌注后(19±10)min.其中少量空气栓子(气泡数量＜10个/s)4例(27％)、中等量空气栓子(10个/s≤气泡数量≤20个/s)7例(47％)、大量空气栓子(气泡数量＞20个/s)4例(27％).与无空气栓子组比较,空气栓子组电刀使用时间延长(P＜0.05).结论宫腔镜手术患者发生空气栓子的原因可能与电刀使用时间有关.
목적 탐토궁강경수술환자발생공기전자적유인.방법 택기추관내마취하행궁강경수술환자35례,ASA분급Ⅰ혹Ⅱ급,년령22 ～ 59세,체중지수18～25 kg/m2.술중용단겁혹쌍겁전도행전절화전응지혈,채용logic vivid Ⅰ채색다보륵초성성상의감측환자가총정맥화상강、하강정맥급심장공기전자적발생정황.근거술중시부발생공기전자분위공기전자조화무공기전자조,분석발생공기전자적가능인소.결과 15례환자발생료공기전자,발생솔위43％,발생시간위팽궁액관주후(19±10)min.기중소량공기전자(기포수량＜10개/s)4례(27％)、중등량공기전자(10개/s≤기포수량≤20개/s)7례(47％)、대량공기전자(기포수량＞20개/s)4례(27％).여무공기전자조비교,공기전자조전도사용시간연장(P＜0.05).결론 궁강경수술환자발생공기전자적원인가능여전도사용시간유관.
Objective To investigate the cause of air emboli during hysteroscopic surgery.Methods Thirty-five ASA Ⅰ or Ⅱ patients,aged 22-59 yr,with a body mass index of 18-25 kg/m2,undergoing hysteroscopic surgery under spinal anesthesia,were involved in this study.Electrocision and electric coagulation were performed using the electrotome during surgery.Air emboli in the common iliac vein,superior vena cava,inferior vena cava and heart were continuously monitored using color Doppler ultrasonic imaging.The patients were divided into 2 groups according to the occurrence of the air embolus:air embolus group and no air embolus group.The possible factors which induced air emboli were analyzed.Results Air emboli developed in 15 patients at ( 19 ±10) min after perfusion with 5％ glucose injection and the incidence was 43％.A small number of air emboli (the numberof bubble ＜ 10/s) occurred in 4 cases.A moderate number of air emboli (10/s≤ the number of bubble≤20/s) occurred in 7 cases.A large number of air emboli (the number of bubble ＞ 20/s) occurred in 4 cases.Compared with no air embolus group,the using time of electrotome was significantly prolonged in air embolus group ( P ＜ 0.05).Conclusion The cause of air emboli during hysteroscopic surgery may be related to the using time of electrotome.