Ozaki S, Nakanishi R, Sakata K, Mitsudomi T, Yasumoto K
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J UOEH. 1995 Sep 1;17(3):199-205. doi: 10.7888/juoeh.17.199.
A 54-year-old woman underwent a left upper lobectomy for lung carcinoma after which hyponatremia developed within 5 days. Her serum concentration of ADH was within normal range disapproving the presence of SIADH frequently associated with lung carcinoma. An endocrinological examination showed panhypopituitarism. From her anamnesis it was seen that there was much perinatal bleeding and amenorrhea. She was diagnosed as suffering from Sheehan syndrome. She was treated with glucocorticoid and beneficial results were obtained. Her serum concentration of natrium returned to normal and she discharged on the 74th postoperative day. We present this paper because we had difficulty in determining that she had Sheehan syndrome, and think that a careful search for a diagnosis before operation is important for the management of the patient during the perioperative and postoperative period.
一名54岁女性因肺癌接受了左上肺叶切除术,术后5天内出现低钠血症。她的抗利尿激素血清浓度在正常范围内,排除了与肺癌常相关的抗利尿激素分泌失调综合征(SIADH)。内分泌检查显示全垂体功能减退。从她的病史中发现有大量围产期出血和闭经。她被诊断为席汉综合征。给予糖皮质激素治疗,取得了良好效果。她的血清钠浓度恢复正常,术后第74天出院。我们撰写本文是因为在确定她患有席汉综合征时遇到了困难,并认为术前仔细寻找诊断对于患者围手术期和术后的管理很重要。