Mitnick P D, Bell S
Reading Hospital and Medical Center, PA.
Am J Kidney Dis. 1990 Jul;16(1):73-5. doi: 10.1016/s0272-6386(12)80789-x.
Transurethral resection of the prostate gland (TURP) has long been associated with disturbances of plasma sodium concentration. Relatively recent substitution of isotonic irrigation solutions has transformed the predominant laboratory abnormality reported from one of hypotonic hyponatremia to one of nearly isotonic hyponatremia with infrequent clinically significant manifestations. We report the unique association of acute and very severe isotonic hyponatremia with rhabdomyolysis and acute renal failure in the post-TURP setting. The mechanism for rhabdomyolysis is postulated to be an impairment of normal maintenance of cellular integrity by virtue of the acuteness and severity of hyponatremia, in the absence of a disturbance of tonicity. Survival after hyponatremia of this severity has not, to our knowledge, been previously reported.
经尿道前列腺切除术（TURP）长期以来一直与血浆钠浓度紊乱有关。相对近期等渗冲洗液的替代，已将报告的主要实验室异常从低渗性低钠血症转变为近等渗性低钠血症，且临床显著表现较少。我们报告了在TURP术后出现急性且极其严重的等渗性低钠血症与横纹肌溶解及急性肾衰竭的独特关联。横纹肌溶解的机制据推测是由于低钠血症的急性和严重性，在张力未受干扰的情况下，正常细胞完整性维持受到损害。据我们所知，此前尚未报道过如此严重的低钠血症后的存活情况。
