中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
36期
23-24
,共2页
宫腔镜%子宫肌瘤%低钠血症
宮腔鏡%子宮肌瘤%低鈉血癥
궁강경%자궁기류%저납혈증
Hysteroccopes%Uterine neoplasms%Hyponatremia
目的 探讨宫腔镜下子宫黏膜下肌瘤电切术致严重低钠血症原因及预防措施.方法 回顾性分析宫腔镜下子宫黏膜下肌瘤电切术患者106例,其中3例发生严重低钠血症.分析其发生的原因并总结处理方法.结果 106例患者中术后严重低钠血症发生率为2.8％(3/106),患者于术后约1h出现恶心、呕吐,查血钠均低于110 mmol/L,膨宫液用量为8000～ 10000 ml,排出量为6300～7500 ml.3例患者均立即给予处理,1例患者静脉滴注乳酸钠林格注射液及0.9％氯化钠,并间断注射呋塞米后15h血钠逐渐恢复正常；2例患者静脉滴注3％氯化钠及15％氯化钾,并注射呋塞米后12h血钠恢复正常,症状消失.结论 避免严重低钠血症的发生一方面可通过术中及时监测膨宫压力、膨宫液体出入量、严格控制手术时间、使用0.9％氯化钠膨宫、预防性使用呋塞米等方式,另一方面术者要提高自己的手术技能,术前认真评估高危因素.
目的 探討宮腔鏡下子宮黏膜下肌瘤電切術緻嚴重低鈉血癥原因及預防措施.方法 迴顧性分析宮腔鏡下子宮黏膜下肌瘤電切術患者106例,其中3例髮生嚴重低鈉血癥.分析其髮生的原因併總結處理方法.結果 106例患者中術後嚴重低鈉血癥髮生率為2.8％(3/106),患者于術後約1h齣現噁心、嘔吐,查血鈉均低于110 mmol/L,膨宮液用量為8000～ 10000 ml,排齣量為6300～7500 ml.3例患者均立即給予處理,1例患者靜脈滴註乳痠鈉林格註射液及0.9％氯化鈉,併間斷註射呋塞米後15h血鈉逐漸恢複正常；2例患者靜脈滴註3％氯化鈉及15％氯化鉀,併註射呋塞米後12h血鈉恢複正常,癥狀消失.結論 避免嚴重低鈉血癥的髮生一方麵可通過術中及時鑑測膨宮壓力、膨宮液體齣入量、嚴格控製手術時間、使用0.9％氯化鈉膨宮、預防性使用呋塞米等方式,另一方麵術者要提高自己的手術技能,術前認真評估高危因素.
목적 탐토궁강경하자궁점막하기류전절술치엄중저납혈증원인급예방조시.방법 회고성분석궁강경하자궁점막하기류전절술환자106례,기중3례발생엄중저납혈증.분석기발생적원인병총결처리방법.결과 106례환자중술후엄중저납혈증발생솔위2.8％(3/106),환자우술후약1h출현악심、구토,사혈납균저우110 mmol/L,팽궁액용량위8000～ 10000 ml,배출량위6300～7500 ml.3례환자균립즉급여처리,1례환자정맥적주유산납림격주사액급0.9％록화납,병간단주사부새미후15h혈납축점회복정상；2례환자정맥적주3％록화납급15％록화갑,병주사부새미후12h혈납회복정상,증상소실.결론 피면엄중저납혈증적발생일방면가통과술중급시감측팽궁압력、팽궁액체출입량、엄격공제수술시간、사용0.9％록화납팽궁、예방성사용부새미등방식,령일방면술자요제고자기적수술기능,술전인진평고고위인소.
Objective To investigate the reason and prevention of severe hyponatremia in hysteroscope treatment of the submucous myoma.Method Retrospective study was done on 106 cases of submucous myoma,3 cases with severe hyponatremia after hysteroscope treatment.Results The rate of hyponatremia was 2.8％(3/106),patients appeared nausea and vomiting 1 hour after hysteroscope treatment,blood sodium was lower than 110 mmol/L,volume of distention liquid was 8000-10000 ml,the volume of discharge was 6300-7500 ml.Three patients were treated immediately,1 patient was given sodium lactate Ringer injection and 0.9％ sodium chloride by intravenous drip,and furosemide by discontinuous injection 15 hours later,the hyponatremia was recovery; 2 patients were given 3％ sodium chloride and 15％ potassium chloride by intravenous drip,and furosemide by injection,12 hours later,the hyponatremia were recovery.Conclusion The prevention of severe hyponatremia complication after hysteroscope treatment of the submucous myoma not only need operate carefully but also need take active preventive measures.
