Hysteroscopic water poisoning manifestations Hysteroscopic water poisoning is characterized by increased blood pressure and decreased pulse, which will then cause brain edema, pulmonary edema, renal edema and hyponatremia. Therefore, once the diagnosis is made, we should immediately stop the operation, improve hypoxia, reduce brain damage, and supplement the oxygen with negative expiratory pressure to pulmonary edema. Diuretic sodium supplementation is very important, and at the same time, pay close attention to the detection of electrolyte and plasma osmotic pressure level.
Because there is a certain relationship between uterine dilation pressure and liquid absorption, the guide suggests that the uterine dilation pressure is 80 ~ 100 mmHg and the flow rate is 200 ~ 300 ml/min. The absorption routes of uterine dilation fluid mainly include entering abdominal cavity through fallopian tube, entering blood through venous sinus and subcutaneous blood vessels. The main factors affecting fluid absorption are intrauterine pressure, average arterial pressure, operation time, endometrial damage, temperature of uterine distention fluid and anesthesia method.
The main clinical manifestations of water poisoning include:
① Pulmonary edema: chest tightness, shortness of breath, cough, pink foam sputum, lung moist rales, etc.
② Brain edema: manifested as restlessness, nausea, headache, blurred vision, disturbance of consciousness, etc.
③ If there is renal insufficiency, it can cause oliguria or anuria;
④ Decreased blood sodium;
⑤ Blood sugar is increased (5% glucose is selected as uterine dilation fluid).
Water poisoning is mainly due to the rupture of uterine venous sinus, which leads to a large amount of lavage fluid entering the blood. The operation time is long and the perfusion pressure is high. Generally, patients can return to normal after treatment (intravenous infusion of hypertonic saline and furosemide) during and after operation, and there will be no sequelae. Uncleared uterine fibroids treated by electrosurgical excision procedure have little chance of self-necrosis. After the body recovers, the operation can be performed again. Hysteroscopy can be used, but it is necessary to explain to the doctor that water poisoning has occurred. You can also choose laparoscopic surgery. The advantage of minimally invasive surgery is that it may be unclean. The disadvantage is that
How to deal with water poisoning during hysteroscopy? Hysteroscopy is a new minimally invasive gynecological diagnosis and treatment technology. It is an optical fiber light source endoscope for intrauterine examination and treatment, including hysteroscope, energy system, light source system, perfusion system and imaging system. It uses the front part of the speculum to enter the uterine cavity, which magnifies the observed part, thus becoming the first choice for gynecological hemorrhagic diseases and intrauterine lesions intuitively and accurately. Hysteroscopy is a new minimally invasive gynecological diagnosis and treatment technology. It is an optical fiber light source endoscope for intrauterine examination and treatment, including hysteroscope, energy system, light source system, perfusion system and imaging system. It uses the front part of the speculum to enter the uterine cavity, which magnifies the observed part, thus becoming the first choice for gynecological hemorrhagic diseases and intrauterine lesions intuitively and accurately. Hello, you are doing hysteromyoma surgery under hysteroscope. You stopped the operation because of water poisoning. Next, you should further check the B-ultrasound to observe your menstruation, menstruation and abdominal pain. Look at the location of myoma under B-ultrasound. If there is no big impact, you can observe the growth of the tumor, and you don't need surgery for the time being, or you may not need surgery for life.
Surgery can be performed after the body recovers. Hysteroscopy can be used, but the doctor should be informed that water poisoning has occurred. Laparoscopic surgery is also optional. The advantage is minimally invasive, but the disadvantage is that it may not be clean. Open surgery is also chosen, and the fibroids are relatively clean. The disadvantage is that the wound is relatively large, which affects the appearance.