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宫腔镜子宫肌瘤切除术中出现严重低钠血症伴中度代谢性酸中毒 - 1 例报告。

Extreme hyponatremia with moderate metabolic acidosis during hysteroscopic myomectomy -A case report-.

机构信息

Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science Gil Medical Center, Incheon, Korea.

出版信息

Korean J Anesthesiol. 2011 Jun;60(6):440-3. doi: 10.4097/kjae.2011.60.6.440. Epub 2011 Jun 17.

DOI:10.4097/kjae.2011.60.6.440
PMID:21738849
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3121093/
Abstract

Excess absorption of fluid distention media remains an unpredictable complication of operative hysteroscopy and may lead to lethal conditions. We report an extreme hyponatremia, caused by using an electrolyte-free 5 : 1 sorbitol/mannitol solution as distention/irrigation fluid for hysteroscopic myomectomy. A 34-year-old female developed severe pulmonary edema and extreme hyponatremia (83 mmol/L) during transcervical endoscopic myomectomy. A brain computed tomography showed mild brain swelling without pontine myelinolysis. The patient almost fully recovered in two days. Meticulous attention should be paid to intraoperative massive absorption of fluid distention media, even during a simple hysteroscopic procedure.

摘要

手术性宫腔镜检查中，液体膨宫介质吸收过多仍然是一种无法预测的并发症，可能导致致命后果。我们报告了一例宫腔镜子宫肌瘤切除术使用无电解质 5：1 山梨醇/甘露醇溶液作为膨宫/灌流介质导致的极端低钠血症。一名 34 岁女性在经宫颈内镜子宫肌瘤切除术中发生严重肺水肿和极端低钠血症（83mmol/L）。脑 CT 显示轻度脑水肿，无脑桥髓鞘溶解。患者在两天内几乎完全康复。即使是在简单的宫腔镜手术中，也应仔细注意术中大量吸收液体膨宫介质的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1530/3121093/b1677803fde1/kjae-60-440-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1530/3121093/b1677803fde1/kjae-60-440-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1530/3121093/b1677803fde1/kjae-60-440-g001.jpg

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