Ziadé Dany, Achkouty Rana, Mrad Roula
Du Service d'Anesthésie-Réanimation, Hôpital Abou-Jaoudé, Beirut, Lebanon.
Can J Anaesth. 2009 Apr;56(4):316-9. doi: 10.1007/s12630-009-9054-5. Epub 2009 Feb 28.
Sever hyponatremia is associated with a high mortality rate. It can occur during procedures requiring irrigation with a glycine solution.
A 31-year old female patient underwent transcervical resection of a uterine myoma under general anesthesia. 35 minutes into surgery, a 41 min(-1) bradycardia with hypertension (150/86 mmHg) was observed, followed by a 50 cmH2O increase in airway pressure and an expired CO2 of 49 mmHg, a sodium of 100 mmoles L(-1) and a negative irrigation fluid water balance of 3000 mL. After administering 600 mL of 3% hypertonic saline, 60 mg of furosemide, performing a transvaginal puncture to release the extravased fluid in the peritoneal cavity, and artificial ventilation for 6 h, positive outcome was finally achieved.
The resorption syndrome during transcervical resection of a uterine myoma is linked to the passage into the blood of the irrigation fluid that contains glycine. The symptoms are hidden during general anesthesia and severe hyponatremia can occur before the syndrome is detected.
严重低钠血症与高死亡率相关。它可发生在需要用甘氨酸溶液冲洗的手术过程中。
一名31岁女性患者在全身麻醉下接受经宫颈子宫肌瘤切除术。手术进行35分钟时，观察到心率41次/分钟伴心动过缓及高血压（150/86 mmHg），随后气道压力升高50 cmH₂O，呼出二氧化碳分压为49 mmHg，血钠100 mmol/L，冲洗液负水平衡3000 mL。给予600 mL 3%高渗盐水、60 mg呋塞米，经阴道穿刺放出腹腔内渗出液，并进行6小时人工通气后，最终取得了良好效果。
经宫颈子宫肌瘤切除术期间的吸收综合征与含甘氨酸的冲洗液进入血液有关。这些症状在全身麻醉期间隐匿，在综合征被发现之前可能发生严重低钠血症。
