运动性横纹肌溶解症误诊分析

运动性横纹肌溶解症 (exerciserhabdomylysis,ER)是由运动后肌纤维崩解断裂 ,其代谢产物释放入血引起的一种非常少见的临床综合征 ,严重者并发急性肾功能衰竭及多脏器功能障碍综合征而危及生命[1] 。该病早期主要以晕厥、发热为主 ,临床表现及实验室检查与中暑相似 ,极易引起误诊。为进一步提高对本病的认识 ,本文报告 2例典型病例 ,并分析其误诊原因。1　病例资料【例 1】　男 ,2 4岁 ,主因晕厥 3小时 ,尿色深伴少尿3天入院。患者于 3天前高强度训练后 ,出现晕厥、意识不清 ,持续 10分钟 ,当时无明显抽搐 ,无大小便失禁。在单位医务室予对…     

横纹肌溶解症患者的护理

横纹肌溶解症(,RM)是横纹肌损伤释放大量肌红蛋白(,Mb)、肌酸磷酸激酶(,CPK)和乳酸脱氢酶(LDH)进入外周血的一组临床和实验室综合征[1]。若不及时治疗,病情进展迅速,病死率较高。现将我院2005年3月~2007年6月6例患者的护理体会报告如下。1临床资料1.1一般资料本组6例,男2例,女4     

横纹肌溶解症致ARF 14例临床分析

我院1996年～2003年收治横纹肌溶解症(Rhabdomyolysis,RM)致急性肾功能衰竭(acute renal failure,ARF)患者14例,经各种血液净化治疗,取得较好临床效果,现报道如下.     

非外伤性横纹肌溶解症的临床特点

目的了解非外伤性横纹肌溶解症(RM)的临床特点和发病机制。方法对11例非外伤性RM的病因和临床表现进行回顾性分析。结果本组病因包括药物性3例,一氧化碳中毒2例,高强度运动2例,高强度农业劳动1例,其他3例。临床表现为肌无力、肌痛、肌肿胀、茶色尿、肾功能衰竭,实验室检验包括肌酸激酶增高,各种电解质紊乱。结论药物是引起非外伤性RM的主要原因,诊断主要依据临床表现和血清肌酸激酶显著升高。急性肾功能衰竭是其严重和导致死亡的主要并发症。     

横纹肌溶解症并发急性肾功能衰竭患者的护理

目的探讨横纹肌溶解症(rhabdomyolysis,RM)合并急性肾功能衰竭(acute renal failure,ARF)患者的护理方法。方法回顾性分析2010年以来第二军医大学长征医院收治的7例RM致ARF患者的临床资料,并总结其护理方法。结果所有患者均于发病48～72h内接受透析治疗。通过治疗与护理,所有患者各项肾功能指标均恢复正常,尿量增多,痊愈出院。结论加强晚夜间血液透析(hemodialysis,HD)的护理,对ARF患者的治疗具有一定的必要性与积极意义。     

运动性横纹肌溶解症致急性肾功能衰竭患者的心理护理

运动性横纹肌溶解症是由于剧烈运动后导致横纹肌损伤，释放大量肌红蛋白进入肾小管引起的肾内梗阻型急性肾功能衰竭（RM—ARF），国外报道^1RM-ARF的发生率为急性肾衰（ARF）的5％～10％。此病病情变化陕，病情重，死亡率高，临床不多见，患者易出现心理问题。我科2003—2007年收治5例运动性横纹肌溶解症致急性肾衰的患者，自患者入院起即对其进行评估，并按计划实施护理对策，以使患者情绪平稳，积极地配合治疗及护理，现报道如下。     

横纹肌溶解症致急性肾功能衰竭的临床分析

创伤引起急性肾功能衰竭 (ＡＲＦ)的死亡率较高 ,特别是创伤引起横纹肌溶解致ＡＲＦ的抢救成功率更低。本文对其 4例致ＡＲＦ进行总结 ,并复习文献 ,以提高对本病的认识 ,提高抢救成功率。一、临床资料我院收治ＡＲＦ共 10 5例 ,病死率为45 %。其中 4例为横纹肌溶解致ＡＲＦ ,2例治愈 ,2例死亡。所有患者入院后均行血液透析及内科综合治疗。例 1为严重鞭打伤 ,其余均为挤压伤综合征 ,例 2～ 4均行肌肉筋膜切开减张术后出现肌肉坏死 ,例 2行截肢术 ,例 1、 2治愈。例 3、 4由于患者或其家属不同意行截肢术 ,抢救无效而死亡 ,见表1。表 1　 4…     

运动性横纹肌溶解症致急性肾功能损伤3例报告及

目的探讨运动性横纹肌溶解症致急性肾功能损伤的病因、临床特点、诊断、治疗及预后。方法回顾性分析收治的3例运动性横纹肌溶解症致急性肾功能损伤患者的临床资料。结果患者表现肌肉酸痛,血清酶学、尿素氮、肌酐明显升高,病情轻者予以补液,病情重者予以血液净化,经治疗后血清酶学及血肌酐恢复正常,脱离透析,预后好。结论对于运动性横纹肌溶解症致急性肾功能损伤,早期预防,及时诊断,早期血液净化治疗,是提高生存率的关键。     

1例因剧烈活动致横纹肌溶解症并急性肾功能衰竭患者的护理

正横纹肌溶解综合症(RM)是由各种原因导致横纹肌细胞损伤而引起溶解的疾病~([1])。横纹肌溶解释放大量肌红蛋白(Mb)和肌酸磷酸激酶(CPK)等酶类、乳酸脱氢酶等物质直接损伤肾小管,引起急性肾小管坏死或阻塞肾小管导致急性肾功能衰竭(ARF)~([2])。通常发生于肌肉严重创伤之后,如过度运动、外伤、肌肉挤压或发生于酒精和药物滥用、感染等过程中。其主要临     

横纹肌溶解症并发急性肾功能衰竭7例的护理

总结7例横纹肌溶解症并发急性肾功能衰竭的护理.护理重点为做好心理护理及疼痛护理,严密观察生命体征,监测肝、肾功能及血生化变化,准确记录24 h尿量,观察尿色的变化,做好血液透析护理,预防感染.经治疗和护理,5例肾功能恢复正常出院,1例转为慢性肾功能衰竭,1例死亡.     

Exertional rhabdomyolysis in a body builder abusing anabolic androgenic steroids.

Rhabdomyolysis, or acute skeletal muscle destruction, may be accompanied by myoglobinaemia, myoglobinuria, and an elevated serum creatine kinase level. This disorder has many potential causes. In this article, the authors describe a case of rhabdomyolysis occurring after vigorous weight lifting by a man who was supplementing his weight-training programme with the intake of anabolic androgenic steroids dispensed to him by a colleague.     

Exertional rhabdomyolysis in unsupervised exercises in a correctional setting: a case study

Unsupervised overexercise in the prison population can lead to exertional rhabdomyolysis, a condition that can lead to kidney damage and/or failure. Knowledge deficit of the risk from this activity will be addressed. Signs and symptoms of rhabdomyolysis and its sequelae will be presented along with a case study. Inter-departmental responsibilities in the correctional setting will be considered. The importance of recognizing the signs and symptoms of this condition by nurses in various clinical settings will also be explored.     

运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习

目的 探讨多学科联合治疗运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓的临床效果。方法 选取河北医科大学第三医院急诊科与血管外科联合治疗的运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓的患者1例,对其临床资料、治疗方案进行回顾性分析,评价临床治疗效果。结果 急诊科采用血液透析治疗急性肾功能不全,血管外科采用清除血栓术治疗透析管相关性血栓形成,患者痊愈出院。结论 本例患者经多学科联合治疗取得了良好的临床效果。     

Exertional hemoglobinuria.

A 16 years old boy had a typical exertional hemoglobinuria after walking with his new leather shoes on. The attacks of hemoglobinuria were associated with the appearance of an unstable hemoglobin in red cells. A slightly decreased fragility curve by 24 hr incubated red cells, the increase of autohemolysis and the appearance of heat labile hemoglobin were observed after exertion. These findings support that exertional hemoglobinuria may be regarded as a transitory erythropathia.     

Exertional compartment syndrome]

OBJECTIVES: To review the literature on chronic exertional compartment syndrome. METHODS: We searched the Medline database with use of the keys words compartment syndrome, exertional, chronic, pressure, and fasciotomy. RESULTS: Exertional compartment syndrome is characterized by pain on exertion, which recedes at rest, and by excessive increase in compartment intramuscular pressure. Intramuscular pressure measurement is the reference diagnostic tool, but it has not been standardized or evaluated. Pressure observed during the first 5 min after exertion stops is more often used in diagnosis. The first studies of noninvasive investigations (magnetic resonance imaging, thallium single-photon emission tomographic imaging, near infrared spectroscopy) revealed their inadequate diagnostic value. The pathophysiological features of exertional compartment syndrome remain unclear: increased muscle bulk, fascia thickness and stiffness, stimulation of fascial sensory stretch-receptors, poor venous return, micromuscular injuries, and small clinical myopathic abnormalities. Treatment includes decreased sport activity or fasciotomy with partial fasciectomy. Several authors have used endoscopically assisted fasciotomy, which retrospective studies have shown to be successful. Long-term outcome studies could investigate the persistence of exertional minor pain and recurrence of the compartment syndrome with this treatment. CONCLUSION: Further studies are required to understand the physiopathology, standardize the intramuscular pressure test and evaluate the pressure threshold values, evaluate noninvasive investigations and specify the long-term outcome of fasciotomy.