자궁경을 통한 점막하근종 절제술시 팽창배지에 의한 폐부종 1예

Abstract

A 45-Year-old para 1-0-1-1 had submucosal myoma diagnosed by ultrasonogram and hysteroscopic examination. During 60 minutes hysteroscopic myomectomy, 8,000 ml of sorbitol-mannitol distention medium was used and 6,500 ml collected, resulting in a deficit of 1,500 ml. The patient received Ringer`s lactate 1,000 ml intravenously. Her urine output was 400 ml. Blood loss was 40 ml. After operation, hyponatremia(115 mEq/L) was developed and pulmonary edema was also diagnosed clinically at that time and later confirmed by chest radiograph. The judicious administration of diuretics and normal saline fluid replacement to prevent overcorrection to hypernatremia resulted in return of serum electrolytes to normal level and resolution of the pulmonary edema by postoperative day 1. We have experienced a case of pulmonary edema during hysteroscopic myomectomy with sorbitol-mannitol distention medium, which is presented with a brief review of literatures. Key Words: Hysteroscopic myomectomy, Pulmonary edema, Hyponatremia, Distention media.

저자들은 자궁경을 이용한 점막하근종절제술을 시행한 환자에서 팽창배지의 흡수에 의한 저나트륨혈증, 수분중독증, 그리고 폐부종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.