Pratesi R, Tonelli R, Torelli P, Giannelli M, Pastorino A, Trebbi G F
U.O. Anestesia e Rianimazione, USSL 8 di Pistoia.
Minerva Anestesiol. 1994 May;60(5):273-6.
Operative hysteroscopy procedures can present complications connected to necessity of kneeping, usually with low viscosity fluids, an uniform distension of uterine cavity. The instilled solutions are reabsorbed through the peritoneum and open uterine venous channels producing a hyperhydration syndrome. The case report shows the rising up of tis syndrome during a hysteroscopy for an uterine myoma resection. The physiopathology includes cardiovascular overload and haemodilution, causing pulmonary, cerebral and tissutal oedema. In this case report the volumes of arterial oxygen saturation and end tidal carbon dioxide obtained on line were the first warning signals. A high CVP value, a plasmatic reduction of Na, albumin, proteins, haemoglobin, haematocrit and osmolarity reflected the excessive fluid reabsorption. For this reason the necessity, during these surgical methods, of considering some practical indications and the absolutely necessary use of clinical and biochemical monitoring systems for these patients.
宫腔镜手术可能会出现与持续灌流需求相关的并发症，通常使用低粘度液体以均匀扩张子宫腔。注入的溶液通过腹膜和开放的子宫静脉通道被重新吸收，从而产生高水化综合征。该病例报告显示了在子宫肌瘤切除宫腔镜检查期间该综合征的出现。其病理生理学包括心血管负荷过重和血液稀释，导致肺水肿、脑水肿和组织水肿。在本病例报告中，在线获得的动脉血氧饱和度和呼气末二氧化碳量是最初的警示信号。中心静脉压（CVP）值升高、血浆中钠、白蛋白、蛋白质、血红蛋白、血细胞比容和渗透压降低反映了液体过度吸收。因此，在这些手术方法中，有必要考虑一些实际指征，并绝对有必要对这些患者使用临床和生化监测系统。
