38 cases of operative cooperation and experience of hysteroscopic electrosurgical excision procedure
, Hysteroscopy lens and hysteroscopy sheath, electricity cut ring, input pipes and output pipes, electric cutting wire after disinfection spare. 2.1 2 Prepare the basic items cervical clamp disinfected forceps dilatation rods, Vaginal probe of the uterus, uterine curette, oval clamp and gynecological perineum conventional dressings packaged sterilization, prepared 5% glucose injection 1000 ~ 3000ml as uterine distention fluid. 2.2 patients with 2.2.1 in patients with burglary after the establishment of an upper extremity intravenous access, bladder lithotomy position to take, and tie legs with knees gently fixed prop leg rack, prop up the leg rack set cotton pad height, according to the patients adjusted prop leg frame height, the perspective of patients with legs apart l10 ~ 120. Elderly patients is relatively small, the electrode plate affixed to the patients buttocks. Routine perineal prepped and draped, wire and operating parts of each instrument is properly connected, power, and in working condition, adjust the brightness of the cold light source, to maintain appropriate brightness, adjust the video converter to clear screen in Figure anesthetic . Vaginal 2.2.2 release expansion of cervical dilatation rods from small to big in order to be able to accommodate hysteroscopy sheath, release hysteroscopy, dilatation close observation of patients with heart rate, blood pressure, breathing and oxygen saturation, abnormal immediately processed with the anesthesiologist. 2.2.3 uterine distention fluid hanging rack hooks, connect the input pipes and output pipes, to ensure the expansion official perfused with unobstructed discharge, electric screen under the surveillance of patients who cut the ring followed by transurethral resection of endometrial Nurse according to the surgeon needs to adjust the electric shear strength, general the transurethral power 50W, removal of tissue debris and sent for pathological examination. 3 experience. 3.1 do preoperative visits, surgery roving nurses to the wards the day before surgery visits patients to the patients about the advantages of surgery and preoperative, postoperative attention to problems so that they lift the psychological pressure, with a good attitude underwent surgery to tie while Zhu Huanzhe preoperative ward nurses do a good job of intestinal and vaginal preparations. 3.2 to do the monitoring and prevention of intraoperative complications, intraoperative complications include: 3.2.1 air embolism hysteroscopy surgery, air embolism can occur. In order to prevent the 34 occurred, take the bladder lithotomy position surgery, to avoid the head lower than hips high. Should be the operating table surface elevation, pay attention to the emptying of the gas inlet pipe, select the minimum distention pressure, if the operation of the patients who need surgery to maintain uterine distention fluid uninterrupted, to prevent air bubbles to escape into the bureaucratic, by Palace The vascular wall rupture caused by air embolism. Surgery in patients with difficulty breathing, blood oxygen saturation decreased precordial auscultation water wheel audio that may occur venous air embolism, immediate rescue. 3.2.2 water poisoning, water intoxication is a uterine distention fluid overload, and water due to the excess absorption. When the long operation time, a large number of uterine distention fluid, roving nurses should patients reported perfusion and excretion. Bureaucratic pressure should be controlled within the in 100mmHg following, surgery should be observed in the disease, water poisoning is suspected, prescribed intravenous diuretics or a small amount of hypertonic saline, and limit fluid intake,
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UGG outlet, blood pressure, bloating, distention fluid pressure should be lowered, quickly prescribed intravenous infusion of oxytocin and dexamethasone. 3.2.4 to prevent electrical burns to carefully check the the distention liquids, avoid using electric secluded quality solution. The intraoperative often check the electrode film, pay attention to the role of the electrode can not directly contact with the metal instrument. 3.3 Instruments and maintenance of the end of surgery, hysteroscopy, and operating parts rinse with water, dried, spare metal joints with paraffin oil to wipe after collection. Cold light wire is not to discount, to avoid damage to the beam. Electric knife, cold light source, optical and video converter, monitors knob zero. (Received :2008-01-18) diagnosis of dry old wins crazy millet pox learning | r new software to help '|. Cll,
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