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This study evaluated the effect of increasing the critical value threshold for hyponatremia combined with systematic intervention on sodium regulation in patients undergoing myomectomy. A retrospective analysis was performed. Patients who underwent myomectomy and received conventional care between March 2014 and March 2019 (n=844) served as the reference group (threshold: 120 mmol/L), while those treated between March 2019 and March 2024 (n=1385) formed the observation group. In the observation group, the hyponatremia critical threshold was raised to 129 mmol/L, alongside targeted interventions including patient education, dynamic sodium monitoring, use of normal saline as the oxytocin solvent, and dietary management. The observation group showed a significantly lower overall incidence of hyponatremia compared with the reference group (21.3% vs. 25.8%, P<0.05). The reduction was more pronounced for moderate-to-severe hyponatremia, decreasing from 5.6% (0.9% severe, 4.7% moderate) to 2.2%, with no severe cases observed. Symptomatic episodes were also reduced (8/31 vs. 25/48). Acute moderate-to-severe hyponatremia occurred predominantly in patients receiving intravenous oxytocin. In conclusion, elevating the hyponatremia critical threshold combined with multidimensional intervention effectively reduces both the incidence and severity of postoperative hyponatremia following myomectomy, supporting its value in early warning and clinical management.