产后出血后弥散性血管内凝血导致子宫切除术后短暂性尿崩症一例

Transient Diabetes Insipidus after Hysterectomy Caused by Disseminated Intravascular Coagulation after Postpartum Hemorrhage:A Case Report

报道临床工作中遇到的1例特殊病例,患者因相对性头盆不称行剖宫产术,发生严重产后出血、弥散性血管内凝血行子宫切除术后出现垂体后叶功能障碍,表现为短暂性尿崩症,临床上极为罕见,对其进行临床分析并复习文献,旨在提高对产后出血后出现类似希恩综合征症状如短暂性尿崩症病例的了解和认识,为临床工作者提供参考。希恩综合征是由于产后大出血引起的缺血性垂体坏死而发生的,通常在产后多年才被诊断出来。而产后很快地出现垂体机能减退引起短暂性尿崩症,临床上不常见,应引起临床工作者的重视,在评估严重产后出血后出现多尿多饮的患者时,应始终警惕中枢性尿崩症的可能性,探讨其原因及治疗方法,以便迅速开展适当的治疗。

The present study reported on a special case of cesarean section due to relative cephalopelvic disproportion.Due to severe postpartum hemorrhage and disseminated intravascular coagulation,hysterectomy was performed,posterior pituitary dysfunction was found and transient diabetes insipidus was presented,which is very rare in clinical practice.Clinical analysis and literature review were conducted on this case.The aim of this study was to improve the understanding of the Sheehan syndrome such as transient diabetes insipidus after postpartum hemorrhage and provide reference for clinical workers.Sheehan syndrome is due to postpartum hemorrhage caused by ischemic pituitary necrosis,usually diagnosed a few years after delivery.However,transient diabetes insipidus caused by hypopituitarism soon after postpartum is not common in clinical practice,which should be paid attention to by clinical workers.When evaluating patients with polyuria and polydipsia after severe postpartum hemorrhage,we should always keep in mind the possibility of central diabetes insipidus,explore its causes and treatment methods,so as to carry out appropriate treatment quickly.