膀胱肿物切除术术中大出血合并急性水中毒一例

A Case of Massive Bleeding Combined with Acute Water Intoxication during Cystoscopic Tumor Resection

摘要: 虽然膀胱肿物手术与前列腺电切术相比较少发生水中毒，但在出血及大量冲洗液使用的情况下仍有风险。临床应重视循环容量与水电解质、酸碱平衡的综合评估，警惕高氯血症型水中毒的发生，及时行血气分析与液体管理。合理的液体复苏与容量控制、体温维持及止血措施是防止病情恶化的关键。本文结合文献分析膀胱肿物切除术中发生大出血和水中毒时的处理，旨在提高临床医生对膀胱肿物切除术也会发生水中毒的认识。

Abstract: Although water intoxication is less likely to occur during bladder tumor surgery than during transurethral resection of the prostate, there are still risks in the event of bleeding and the use of large amounts of irrigation fluid. Clinically, it is important to prioritize comprehensive assessment of circulating volume, water, electrolyte, and acid-base balance, be vigilant against the development of hyperchloremic water intoxication, and promptly perform blood gas analysis and fluid management. Appropriate fluid resuscitation and volume control, temperature maintenance, and hemostatic measures are key to preventing worsening of the condition. This article, based on a literature review, examines the management of massive bleeding and water intoxication during bladder tumor resection, aiming to raise clinicians’ awareness of the potential for water intoxication during bladder tumor resection.