中国血液净化

›› 2007, Vol. 6 ›› Issue (2): 67-70.

• 论著 • 上一篇    下一篇

连续性血液净化治疗对横纹肌溶解症抢救的临床研究

彭侃夫1 吴雄飞1 孙 岩1 王军霞1 吴 亿1 孟建中2   

  1. 1. 400038 重庆，第三军医大学西南医院肾科 2. 250013 济南，济南军区总医院血液净化科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-02-12 发布日期:2007-02-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-02-12 Published:2007-02-12

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摘要： 目的 探讨连续性血液净化(CBP)治疗在横纹肌溶解症(rhabdomyolysis,RM)抢救中的作用。方法 选择第三军医大学西南医院肾科，济南军区总医院血液净化科1998～2005年42例横纹肌溶解症患者回顾性地研究，其临床救治过程，分析其病情变化规律，探讨治疗时机及连续性血液净化治疗对预后的影响。结果 ①患者主要表现为肌红蛋白尿及以肌酸磷酸肌酶(CPK)明显的升高。临床症状不典型，易误诊；②经过连续性血液净化治疗及综合治疗，38例痊愈。死亡4例，死亡原因为多器官功能衰竭(MODS)。结论 ①患者均为青壮年，易忽视，易误诊为中暑；②早期诊断、及时应用连续性血液净化治疗是降低病死率的关键；CBP不但可清除血肌红蛋白，而且降低MODS的发生。

关键词: 横纹肌溶解症, 连续性血液净化, 多器官功能衰竭

Abstract: Objective To explore the effect of continuous blood purification(CBP) in treatment of rhabdomyolysis(RM). Methods Clinical data and treating procedure of 42 cases being diagnosed as rhabdomyolysis between 1998～2005 were retrospectively studied, changes of clinical status, therapy opportunity and prognosis of RM after CBP therapy were analyzed. Results ①The main clinical features were myohemoglobinuria and the significantly increased serum creatine phosphokinase(CPK). RM was easily misdiagnosed because of nonspecific symptoms. ②Being treated with CBP and conservative therapy, 38 cases recovered, 4 patients died, the cause of death was multiple organ dysfunction syndrome(MODS). Conclusions ①Young and middle aged RM patients are easily ignored or misdiagnosed as heart stroke. ②Earlier diagnosed as RM and treated with CBP is the key treatment to decrease mortality rate. CBP can not only clean myohemoglobin in blood,but also reduce the incidence of MODS efficiently.

Key words: Continuous blood purification(CBP), Multiple organ dysfunction syndrome (MODS)

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