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盐水引产过程中使用缩宫素导致的水中毒

Water intoxication associated with oxytocin administration during saline-induced abortion.

作者信息

Lauersen N H, Birnbaum S J

出版信息

Am J Obstet Gynecol. 1975 Jan 1;121(1):2-6. doi: 10.1016/0002-9378(75)90965-5.

Abstract

Four cases of water intoxication in connection with oxytocin administration during saline-induced abortions are described. The mechanism of water intoxication is discussed in regard to these cases. Oxytocin administration during midtrimester-induced abortions is advocated only if it can be carried out under careful observations of an alert nursing staff, aware of the symptoms of water intoxication and instructed to watch the diuresis and report such early signs of the syndrome as asthenia, muscular irritability, or headaches. The oxytocin should be given only in Ringers lactate or, alternately, in Ringers lactate and a 5 per cent dextrose and water solutions. The urinary output should be monitored and the oxytocin administration discontinued and the serum electrolytes checked if the urinary output decreases. The oxytocin should not be administered in excess of 36 hours. If the patient has not aborted by then the oxytocin should be discontinued for 10 to 12 hours in order to perform electrolyte determinations and correct any electrolyte imbalance.

摘要

本文描述了4例在盐水引产过程中因使用催产素而导致水中毒的病例。针对这些病例讨论了水中毒的机制。仅当在警觉的护理人员仔细观察下进行时,才提倡在孕中期引产时使用催产素,护理人员应了解水中毒的症状,并被指示观察利尿情况,并报告该综合征的早期迹象,如乏力、肌肉易激惹或头痛。催产素应仅用乳酸林格氏液给药,或者交替使用乳酸林格氏液和5%葡萄糖水溶液。应监测尿量,如果尿量减少,应停止使用催产素并检查血清电解质。催产素的使用不应超过36小时。如果届时患者尚未流产,应停止使用催产素10至12小时,以便进行电解质测定并纠正任何电解质失衡。

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