切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 35 -38. doi: 10.3877/cma.j.issn.1674-0785.2020.01.008

所属专题: 文献

临床研究

运动性横纹肌溶解症37例诊治分析
王劭亮1, 陈蓉2, 王明欢3,()   
  1. 1. 430061 武汉,武警湖北省总队医院门诊部
    2. 430061 武汉,武警湖北省总队医院特色医学二科
    3. 430015 武汉,华中科技大学同济医学院附属同济医院普通外科
  • 收稿日期:2019-07-02 出版日期:2020-01-15
  • 通信作者: 王明欢

Diagnosis and treatment of 37 cases of athletic rhabdomyolysis

Shaoliang Wang1, Rong Chen2, Minghuan Wang3,()   

  1. 1. Outpatient Department, Hubei Provincial Armed Police Corps Hospital, Wuhan 430061, China
    2. Second Department of Characteristic Medicine, Hubei Provincial Armed Police Corps Hospital, Wuhan 430061, China
    3. Department of General Surgery, Tongji Hospital of Tongji Medical College Huazhong University of Science and Technology, Wuhan 430015, China
  • Received:2019-07-02 Published:2020-01-15
  • Corresponding author: Minghuan Wang
  • About author:
    Corresponding author: Wang Minghuan, Email:
引用本文:

王劭亮, 陈蓉, 王明欢. 运动性横纹肌溶解症37例诊治分析[J/OL]. 中华临床医师杂志(电子版), 2020, 14(01): 35-38.

Shaoliang Wang, Rong Chen, Minghuan Wang. Diagnosis and treatment of 37 cases of athletic rhabdomyolysis[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(01): 35-38.

目的

探讨运动性横纹肌溶解症的临床诊治方法,提升治疗效果。

方法

回顾性分析武警湖北省总队医院和华中科技大学同济医院2007年10月至2018年11月收治的37例运动性横纹肌溶解症患者的临床资料。37例患者予以抗感染、补充血容量、止吐、退热、碱化尿液等对症治疗。8例急性肾功能不全患者,血肌酐>442 μmol/L或者血钾>6.5 mmol/L,采用血液透析治疗。

结果

患者平均住院时间9(4~25)d。37例患者出院时血清肌酸激酶值均降至正常范围或轻度异常升高。8例急性肾功能不全患者经血液透析治疗后,复查肾功能、电解质均恢复正常。

结论

运动性横纹肌溶解症首发症状多样,容易误诊、漏诊。早期检查血清肌酸激酶、肌红蛋白有利于及早确定诊断。抗感染治疗、对症治疗、补充血容量、碱化尿液、血液透析等综合治疗有利于患者预后。对运动性横纹肌溶解症所致重度急性肾功能不全患者,行血液透析治疗能有效挽救肾功能,降低患者病死率。

Objective

To explore the clinical diagnosis and treatment of exertional rhabdomyolysis to improve its therapeutic effects.

Methods

The clinical data of 37 cases of exertional rhabdomyolysis were retrospective analyzed. All cases were given symptomatic treatments such as anti-infection, blood volume supplementation, antiemetic and antipyretic treatments, and alkalization of urine. Six patients with severe acute renal insufficiency, serum creatinine over 442 μmol/L, or hyperkalemia were treated by hemodialysis.

Results

The average hospitalization time was 9 (range, 4-25) days. Serum creatine phosphokinase decreased to normal in 37 patients at discharge. After hemodialysis, renal function and electrolytes returned to normal in the six patients with severe acute renal insufficiency.

Conclusion

The initial symptoms of exertional rhabdomyolysis are various and easy to be misdiagnosed or missed. Early detection of serum creatine phosphokinase and myoglobin is helpful for early diagnosis. Symptomatic treatments, such as blood volume supplementation, alkalization of urine, and hemodialysis, are beneficial to the prognosis of patients. Early hemodialysis can effectively improve renal function and reduce mortality in patients with severe acute renal insufficiency caused by exertional rhabdomyolysis.

1
Dawley C. Myalgias and myopathies: Rhabdomyolysis [J]. FP Essent, 2016, 440(1): 28-36.
2
Harrois A, Libert N, Duranteau J. Acute kidney injury in trauma patients [J]. Curr Opin Crit Care, 2017, 23(6): 447-456.
3
Heard H, Barker J. Recognizing, diagnosing, and treating rhabdomyolysis [J]. JAAPA, 2016, 29(5): 29-32.
4
Chavez LO, Leon M, Einav S, et al. Beyond muscle destruction:a systematic review of rhabdomyolysis for clinical practice [J]. Crit Care, 2016, 20(1): 135-140.
5
Parekh R, Care DA, Tainter CR. Rhabdomyolysis:advances in diagnosis and treatment [J]. Emerg Med Pract, 2012, 14(3): 1-15.
6
Safari S, Yousefifard M, Hashemi B, et al. The value of serum creatine kinase in predicting the risk of rhabdomyolysis-induced acute kidney injury:a systematic review and meta-analysis [J]. Clin Exp Nephrol, 2016, 20(2): 153-161.
7
Safari S, Yousefifard M, Hashemi B, et al. The role of scoring systems and urine dipstick in prediction of rhabdomyolysis-induced acute kidney injury:a systematic review [J]. Iran J Kidney Dis, 2016, 10(3): 101-106.
8
Watson JD, Gifford SM, Clouse WD. Biochemical markers of acute limb ischemia, rhabdomyolysis, and impact on limb salvage [J]. Semin Vasc Surg, 2014, 27(3): 176-181.
9
Lee G. Exercise-induced rhabdomyolysis [J]. R I Med J, 2014, 97(11): 22-24.
10
Repizo LP, Malheiros DM, Yu L, et al. Biopsy proven acute tubular necrosis due to rhabdomyolysis in a dengue fever patient:a case report and review of literature [J]. Rev Inst Med Trop Sao Paulo, 2014, 56(1): 85-88.
11
Sudarsanan S, Omar AS, Pattath RA, et al. Acute kidney injury associated with rhabdomyolysis after coronary artery bypass graft: a case report and review of the literatures [J]. BMC Res Notes, 2014, 17(7): 152-156.
12
Panizo N, Rubio-Navarro A, Amaro-villalobos JM, et al. Molecular mechanisms and novel therapeutic approaches to rhabdomyolysis-induced acute kidney injury [J]. Kidney Blood Press Res, 2015, 40(5): 520-532.
13
Zeng X, Zhang L, Wu T, et al. Continuous renal replacement therapy(CRRT) for rhabdomyolysis [J]. Cochrane Database Syst Rev, 2014, 15(6): 560-565.
14
马志宇,苏靖翠,佟淼,等. 124例横纹肌溶解征诊治体会 [J]. 中国医科大学学报, 2013, 42(10): 953-954.
[1] 张婧琦, 江洋, 孙佳璐, 唐兴喆, 赵宇飞, 崔颖, 李信响, 戴景月, 傅琳, 彭新桂. 基于肾周CT特征结合血清肌酐水平探讨脓毒症伴急性肾损伤的早期识别[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 285-292.
[2] 樊恒, 孙敏, 朱建华. 红景天苷通过抑制PI3K/AKT/mTOR信号通路对大鼠脓毒症急性肾损伤的保护作用[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(03): 188-195.
[3] 张锦丽, 席毛毛, 褚志刚, 栾夏刚, 陈诺, 王德运, 谢卫国. 大面积烧伤患者发生早期急性肾损伤的危险因素分析[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(04): 282-287.
[4] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会. 中国肝移植受者肾损伤管理临床实践指南(2023版)[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 276-288.
[5] 杜军霞, 赵小淋, 王浩然, 高志远, 王曼茜, 万楠熙, 张冬, 丁潇楠, 任琴琴, 段颖洁, 汤力, 朱晗玉. 2 型糖尿病的血液透析患者肠道微生物组学高通量测序分析[J/OL]. 中华肾病研究电子杂志, 2024, 13(06): 313-320.
[6] 张少青, 吕玉风, 董海霞. 中性粒细胞百分比/白蛋白比值对维持性血液透析患者全因死亡的预测作用[J/OL]. 中华肾病研究电子杂志, 2024, 13(06): 321-326.
[7] 陈意志. 核磁共振钆造影剂导致的肾源性系统性纤维化[J/OL]. 中华肾病研究电子杂志, 2024, 13(06): 358-358.
[8] 苏朝江, 刘佳丽, 姜燕, 许厅, 刘俪婷, 陈彦, 刘宗旸. 血透患者小直径动脉经皮腔内血管成形术后行动静脉内瘘术的疗效[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 249-255.
[9] 周敏, 徐阳, 胡莹, 黄先凤. 维持性血液透析患者血清β-CTX、N-MID 和PICP 与冠状动脉钙化的关系及其诊断价值[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 256-260.
[10] 杜霞, 马梦青, 曹长春. 造影剂诱导的急性肾损伤的发病机制及干预靶点研究进展[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 279-282.
[11] 郭俊楠, 林惠, 任艺林, 乔晞. 氨基酸代谢异常在急性肾损伤向慢性肾脏病转变中的作用研究进展[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 283-287.
[12] 袁楠, 黄梦杰, 白云凤, 李晓帆, 罗从娟, 陈健文. 急性肾损伤-慢性肾脏病转化小鼠模型制备的教学要点及学习效果分析[J/OL]. 中华肾病研究电子杂志, 2024, 13(04): 226-230.
[13] 司楠, 孙洪涛. 创伤性脑损伤后肾功能障碍危险因素的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 300-305.
[14] 沈炎, 张俊峰, 唐春芳. 预后营养指数结合血清降钙素原、胱抑素C及视黄醇结合蛋白对急性胰腺炎并发急性肾损伤的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 536-540.
[15] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?