为进一步提升我国宫腔镜术者对宫腔镜液体管理风险的认知水平，规范液体超负荷与血管内吸收综合征(operative hysteroscopy intravascular absorption syndrome，OHIA)的防治能力，中国妇幼保健协会宫内疾病防治专业委员会组织相关专业专家，制定本专家推荐意见，重点涵盖OHIA的发病相关因素、膨宫介质管理要点、诊断、治疗和预防规范。提出宫腔镜手术中遵循最低有效膨宫压力原则；阐述负欠量的影响因素和监测要点；总结了OHIA液体超负荷、急性稀释性低钾/低钠血症的临床表现、辅助检查，以及OHIA紧急处理流程；并强调OHIA重在预防，提出"4L"法则和"4E"法则。最后，提出全程自动化的宫腔镜液体管理对降低OHIA的重要价值，并指出了未来发展的方向。

To improve Chinese hysteroscopic surgeons′ awareness of fluid management risks and standardize the prevention and treatment of operative hysteroscopy intravascular absorption syndrome (OHIA), these expert recommendations summarize the pathogenic factors of OHIA, standardized management of uterine distension media, as well as unified diagnosis, treatment and prevention strategies. The recommendations propose adhering to the principle of minimum effective intrauterine distension pressure during hysteroscopy, clarify influencing factors and monitoring key points of fluid deficit, and conclude clinical manifestations, auxiliary examinations of OHIA-related fluid overload and acute dilutional hypokalemia/hyponatremia, alongside the standardized emergency management workflow for OHIA. This paper highlights that prevention is the priority for OHIA control, and puts forward the "4L" rule and "4E" rule for clinical prevention. Finally, it highlights the critical value of fully automated intraoperative hysteroscopic fluid management in reducing OHIA risk, and prospects future research and development directions in this field.