Bennett K L, Ohrmundt C, Maloni J A
University of Wisconsin Hospital and Clinics, Madison, USA.
AORN J. 1996 Nov;64(5):792-9. doi: 10.1016/s0001-2092(06)63267-5.
Hysteroscopic procedures, which are an alternative to hysterectomy for surgical treatment of menorrhagia and uterine fibroids, place women at risk for intravasation of uterine distention fluid. Intravasation can produce fluid overload, pulmonary edema, congestive heart failure, and electrolyte imbalances. To examine risk factors for and evaluate nursing interventions to decrease the incidence of intravasation, the researchers compared mean arterial pressures (MAPs) and intrauterine pressures (IUPs) in two groups of women undergoing elective outpatient hysteroscopic procedures. The experimental group consisted of 20 women in whom fluid infusion pump pressures were maintained below the women's MAPs. The control group consisted of 20 women whose fluid infusion pump pressures were set at random. Distention fluid deficits and the total infused distention fluid volume differed significantly between the two groups, supporting the study hypothesis that maintaining equilibrium between women's IUPs and MAPs decreases the risk of uterine distention fluid absorption into the vasculature and fluid overload complications. Perioperative nurses need to monitor women's MAPs before and during hysteroscopic procedures and maintain fluid infusion pump pressures at or below women's MAPs to decrease the potential for intravasation.
宫腔镜手术是子宫切除术治疗月经过多和子宫肌瘤的替代手术方法，但会使女性面临子宫扩张液血管内灌注的风险。血管内灌注可导致液体超负荷、肺水肿、充血性心力衰竭和电解质失衡。为了研究血管内灌注的危险因素并评估降低其发生率的护理干预措施，研究人员比较了两组接受择期门诊宫腔镜手术的女性的平均动脉压（MAP）和子宫内压（IUP）。实验组由20名女性组成，她们的输液泵压力维持在其MAP以下。对照组由20名女性组成，她们的输液泵压力是随机设定的。两组之间的扩张液缺失量和总输注扩张液量有显著差异，这支持了研究假设，即维持女性IUP和MAP之间的平衡可降低子宫扩张液吸收进入血管系统和液体超负荷并发症的风险。围手术期护士需要在宫腔镜手术前和手术期间监测女性的MAP，并将输液泵压力维持在女性MAP或以下，以降低血管内灌注的可能性。
