Wegmüller Barbara, Hug Kerstin, Meier Buenzli Charlotte, Yuen Bernd, Maggiorini Marco, Rudiger Alain
Medical Intensive Care Unit, University Hospital Zurich, Raemistraße 100, 8091 Zurich, Switzerland.
Crit Care Res Pract. 2011;2011:140381. doi: 10.1155/2011/140381. Epub 2011 Mar 29.
We report on a 43-year-old patient undergoing a hysteroscopic myomectomy. After 80 minutes of operation, the patient developed laryngeal edema, requiring emergency tracheostomy. Hyponatremia (serum sodium 78 mmoL/L) indicated an irrigation fluid absorption. The patient developed shock, acute respiratory distress syndrome, acute renal failure, and diffuse intravascular coagulopathy. Resuscitation including continuous venovenous hemodiafiltration was required. Finally, the patient made a full clinical recovery. Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.
我们报告了一名43岁接受宫腔镜子宫肌瘤切除术的患者。手术80分钟后，患者出现喉水肿，需要紧急气管切开术。低钠血症（血清钠78 mmol/L）提示灌流液吸收。患者出现休克、急性呼吸窘迫综合征、急性肾衰竭和弥散性血管内凝血。需要进行包括持续静脉血液滤过在内的复苏治疗。最终，患者实现了完全临床康复。宫腔镜检查通常风险较低。然而，灌流液的吸收可导致危及生命的液体超负荷和电解质紊乱。精确的液体平衡和限制手术时间可预防这些并发症。
