Muzii Ludovico, Bellati Filippo, Manci Natalina, Zullo Marzio A, Angioli Roberto, Panici Pierluigi Benedetti
Department of Obstetrics and Gynecology, Campus Bio-Medico, University of Rome, Rome, Italy.
Fertil Steril. 2005 Jul;84(1):148-53. doi: 10.1016/j.fertnstert.2005.01.111.
To evaluate by serial ultrasound scans how long a Ringer's lactate instillation remains in the peritoneal cavity after laparoscopy.
Prospective, randomized, double blind, clinical trial.
Tertiary care, university hospital.
PATIENT(S): Thirty-six patients undergoing diagnostic or minor operative laparoscopy.
INTERVENTION(S): At the end of laparoscopy, the patients were tilted to an anti-Trendelenburg position and all fluid was aspirated. The patients were then randomized to receive an instillation of 300 mL of Ringer's lactate or no fluid instillation. Serial transvaginal ultrasound scans were performed at the end of surgery and at 24, 48, and 96 hours after the surgery.
MAIN OUTCOME MEASURE(S): Through direct measurements of scalar fluid volumes instilled in the operating room and real-time ultrasound comparisons, an empiric formula was calculated to correlate actual intraperitoneal volumes to ultrasonically derived measurements of fluid pockets. With this formula, the volume of intraperitoneal fluid at 24, 48, and 96 hours after surgery was calculated.
RESULT(S): Twenty-four hours after surgery, a mean volume of 184 mL was present in the Ringer's lactate group versus 46 mL in the control group. At 48 hours after surgery, the mean volumes were 78 mL versus 30 mL, respectively. No statistically significant differences were found after 96 hours.
CONCLUSION(S): Peritoneal absorption of instilled crystalloids is traditionally reported to be 30 to 60 mL/hour. We report detecting statistically significant amounts of fluid at 24 and 48 hours after surgery, after infusion of 300 mL of Ringer's lactate. This suggests that fluid remains in the peritoneal cavity longer than traditionally believed.
通过系列超声扫描评估腹腔镜检查后乳酸林格氏液在腹腔内留存的时间。
前瞻性、随机、双盲临床试验。
三级医疗大学医院。
36例行诊断性或小型手术腹腔镜检查的患者。
在腹腔镜检查结束时，将患者置于头高足低位并吸出所有液体。然后将患者随机分为两组，一组接受300毫升乳酸林格氏液灌注，另一组不进行液体灌注。在手术结束时以及术后24、48和96小时进行系列经阴道超声扫描。
通过直接测量手术室中灌注的标量液体体积并进行实时超声比较，计算出一个经验公式，以将实际腹腔内体积与超声得出的液体积聚测量值相关联。使用该公式计算术后24、48和96小时的腹腔内液体体积。
术后24小时，乳酸林格氏液组的平均液体量为184毫升，而对照组为46毫升。术后48小时，平均液体量分别为78毫升和30毫升。96小时后未发现统计学上的显著差异。
传统上报道，腹腔对灌注晶体液的吸收速度为每小时30至60毫升。我们报告称，在输注300毫升乳酸林格氏液后，术后24小时和48小时检测到有统计学意义的液体量。这表明液体在腹腔内留存的时间比传统认为的更长。
