Soroker D, Ezri T, Lurie S, Feld S, Savir I
Department of Anesthesia, Kaplan Hospital, Rehovot, Israel.
Can J Anaesth. 1991 Mar;38(2):225-6. doi: 10.1007/BF03008151.
A rare case of the syndrome of inappropriate antidiuretic hormone secretion occurring after minor surgery is presented. A ten-year-old, previously healthy boy underwent general anaesthesia for detorsion and right orchiopexy. Throughout the operations, which lasted for one hour, he received 120 ml Ringer's lactate solution. The immediate postoperative period was uneventful. Twenty-two hours postoperatively he was found unconscious with generalized tonic-clonic seizures. Simultaneously obtained serum sodium concentration (121 mEq.L-1) serum osmolarity (265 mEq.L-1), urine sodium concentration (87 mEq.L-1) and urine osmolarity (525 mEq.L-1) suggested inappropriate antidiuretic hormone secretion which was confirmed by an elevated serum arginine-vasopressin (AVP) level of 14.5 pcg.ml-1 (normal 1-5 pcg.ml-1) measured by radioimmune assay. He was treated with a single iv dose of 30 mg furosemide and fluid restriction, which produced a gradual increase of his serum sodium concentration to normal within two days. He was well during the remainder of his hospitalization.
本文报告了一例小手术后发生抗利尿激素分泌不当综合征的罕见病例。一名10岁、既往健康的男孩因睾丸扭转复位术和右侧睾丸固定术接受全身麻醉。在持续一小时的手术过程中，他接受了120毫升乳酸林格氏液。术后即刻情况平稳。术后22小时，他被发现昏迷并伴有全身强直阵挛性发作。同时测得的血清钠浓度（121 mEq.L-1）、血清渗透压（265 mEq.L-1）、尿钠浓度（87 mEq.L-1）和尿渗透压（525 mEq.L-1）提示抗利尿激素分泌不当，通过放射免疫测定法测得血清精氨酸血管加压素（AVP）水平升高至14.5 pg.ml-1（正常为1-5 pg.ml-1），证实了这一点。他接受了单次静脉注射30毫克呋塞米和液体限制治疗，两天内血清钠浓度逐渐恢复正常。在住院的剩余时间里他情况良好。
