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经尿道精囊镜检查期间可能由碘伏引起的全身性碘中毒:一例病例报告及文献综述

Possible iodophor-induced systemic iodine toxicity during transurethral seminal vesiculoscopy: a case report and literature review.

作者信息

Zhang Meng, Zhao Nan, Zhang Huanhuan, Li Jianli

机构信息

Department of Anesthesia, Hebei General Hospital, Shijiazhuang, 050051, China.

Department of Anesthesia, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.

出版信息

BMC Urol. 2025 May 10;25(1):118. doi: 10.1186/s12894-025-01787-7.

Abstract

RATIONALE

Iodophor, a disinfectant composed of iodine complexed with a surfactant, is extensively employed for preoperative skin preparation, burn wound management, and mucosal disinfection. Despite its extensive application in clinical practice, emerging clinical evidence has documented associations between iodophor irrigation and acute kidney injury in human. However, systemic iodine toxicity after the seminal vesicle was irrigated with iodophor during transurethral seminal vesiculoscopy (TUSV) has not been previously described.

PATIENT CONCERNS

We report the case of a 70-year-old man who developed transient hypotension, vomiting, confusion, and profound lactic acidosis after the seminal vesicles were irrigated with iodophor.

DIAGNOSES

The patient was diagnosed with confusion and profound lactic acidosis secondary to the seminal vesicle was irrigated with iodophor.

INTERVENTIONS

The patient was admitted to the intensive care unit (ICU), and continuous venovenous haemodiafiltration (CVVH) was initiated 3 h after ICU admission.

OUTCOMES

After six days, the patient's condition improved, allowing the cessation of CVVH. He was discharged from the hospital on the 22nd day after being transferred to the ICU.

CONCLUSION

This case highlights the typical characteristics of iodophor absorption during its regular application. Here, we report the first case of systemic iodine toxicity caused by iodophor irrigation during transurethral seminal vesiculoscopy.

摘要

理论依据

碘伏是一种由碘与表面活性剂络合而成的消毒剂,广泛用于术前皮肤准备、烧伤创面处理和黏膜消毒。尽管其在临床实践中应用广泛,但新出现的临床证据表明,碘伏冲洗与人类急性肾损伤之间存在关联。然而,经尿道精囊镜检查(TUSV)期间用碘伏冲洗精囊后发生全身碘中毒的情况此前尚未见报道。

患者情况

我们报告了一例70岁男性患者,在用碘伏冲洗精囊后出现短暂性低血压、呕吐、意识模糊和严重乳酸性酸中毒。

诊断

患者被诊断为因用碘伏冲洗精囊继发意识模糊和严重乳酸性酸中毒。

干预措施

患者被收入重症监护病房(ICU),入住ICU 3小时后开始持续静静脉血液滤过(CVVH)。

结果

六天后,患者病情好转,CVVH得以停止。转至ICU后第22天,患者出院。

结论

本病例突出了碘伏在常规应用过程中吸收的典型特征。在此,我们报告了首例经尿道精囊镜检查期间碘伏冲洗导致全身碘中毒的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05fb/12065135/70f47ca958d7/12894_2025_1787_Fig1_HTML.jpg

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