Huang Hui-Wen, Lee Shu-Chuan, Ho Wai-Meng, Lai Hui-Chin, Juang Sin-Ei
Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 2003 Sep;41(3):149-54.
Complications arising from hysteroscopy are relatively rare events. They occur more frequently with operative hysteroscopy than with diagnostic hysteroscopy. Hysteroscopic procedures, which are alternatives to hysterectomy for surgical treatment of menorrhagia and uterine fibroids, place women to run the risk of intravasation of uterine distention fluid. Excessive intravasation can entail fluid overload, pulmonary edema, congestive heart failure, and electrolyte imbalances. The prerequisite for treatment of hysteroscopic fluid overload is knowing the nature of the intravasation fluid and it should be promptly treated to prevent neurological sequelae. Almost all serious complications of operative hysteroscopy can be avoided if proper precautions are taken and close communication is maintained between the gynecologic surgeon, the anesthesiologist, and nursing staff. Here, we present two cases of fluid overload with acute pulmonary edema and electrolyte imbalance from hysteroscopy with different distention media.
宫腔镜检查引起的并发症相对少见。与诊断性宫腔镜检查相比，手术宫腔镜检查时并发症更常发生。宫腔镜手术是治疗月经过多和子宫肌瘤的手术方式，可替代子宫切除术，但会使女性面临子宫扩张液血管内灌注的风险。过多的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。治疗宫腔镜液体超负荷的前提是了解灌注液的性质，应及时治疗以预防神经后遗症。如果采取适当的预防措施，并在妇科外科医生、麻醉师和护理人员之间保持密切沟通，几乎所有手术宫腔镜检查的严重并发症都可以避免。在此，我们介绍两例因使用不同扩张介质进行宫腔镜检查导致液体超负荷伴急性肺水肿和电解质失衡的病例。
