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血液净化技术在过度训练致横纹肌溶解症并发急性肾衰竭救治中的作用
Chinese Journal of Blood Purification ›› 2004, Vol. 3 ›› Issue (9) : 468-470.
PDF(3725 KB)
PDF(3725 KB)
Objective To explore the effect of blood purification therapy for acute renal failure(ARF) caused by rhabdomyolysis being induced by excess of military training. Methods Reviewing the clinical data and treating procedure of the 37 cases being diagnosed hyposthenic rhabdoryolysis after excess of military trains between 1993~2003, analyzed the influenle of different therapy opportunity and blood purification style on prognosis of ARF. Results ①Seasons of onset were autumn and summer, main symptoms were vomiting, fever, dizziness, muscle ache and other nonspecific symptoms. Among them 28 cases(75.67%) were diagnosed acute gastroenteritis or gastrointestinal type flu before hospitalization, 21 cases (56.75%) were treated with aminoglycoside antibiotic such as gentamicin which could injure kidney. Above clinical features made the diagnosis and treatment for ARF more complex; ②Serum levels of creatine phosphokinase (CK) which positively related with levels of serum kalium, urea nitrogen and creatinine significantly rose before muscle ache and myoglobin occurrence in urine (P<0.05); ③Being treated with continuous renal replacement therapy treatment (CRRT),hemodialysis (HD) and comprehensive therapy, renal function of 31 cases recovered from oliguria stoge; 6 pationts died, the cause of death was of multiple organ system failure. Conclusions ① The hot and humid environment would aggravate systemic reactions and tissue damage after excess of training, the plasma level increment of CK is one of the important mark of degeneration and dissolve of striated muscle; ② The more organs dysfunction, the higher the death rate, the keys to decrease mortality rate of ARF occured in rhabdomyolysis patients are to diagnose early, eliminate the causes promptly, and treat with blood purification more rationally; ③ Curative effect of CRRT is better than HD, which could improve prognosis of ARF.
Rhabdomyolysis / Acute renal failure / Continuous renal replacement therapy
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