恶性高热回顾性对比分析

目的分析我国2004年至2008年恶性高热(MH)报道病例的临床资料并与以前作对比,探讨MH诊断、治疗的进展和需注意的问题。方法检索中文科技期刊全文数据库、万方数据资源系统、中国知网全文数据库、中国生物医学文献数据库,收集我国2004年至2008年报道的21例MH病例的临床资料,分析其流行病学、首发症状、临床特点、治疗及转归,并与2004年之前的病例作比较,探讨其改变。结果与2004年前相比,我国报道恶性高热的患者仍以男性为主,发病年龄较前增大,高发科室为普外科、口腔外科和神经外科,首发症状以呼气末二氧化碳分压升高为主,目前尚未推广实行咖啡因-氟脘骨骼肌离体收缩试验进行诊断,治疗上血液净化的使用是新的亮点,病死率较前有所下降。结论我国近几年来报道MH病例数、诱发药物增多,诊断、治疗水平较前提高,病死率较前下降,但仍需完善我国的MH监测体制,继续加强培训,推广咖啡因-氟脘骨骼肌离体收缩试验的应用,注意加强乳酸的动态监测,考虑推广使用丹曲洛林、建立统一标准的MH诊疗常规。

Retrospective analysis of malignant hyperthermia

Objective To analyze the recent（2004-2008）clinical datas of malignant hyperthermia（MH） in China and compare them with the previous ones（1978-2004）.Methods Twenty-one cases of MH occurred from 2004-2008 were reviewed and analyzed.Results MH still occured more frequently in males than females.The average age of MH patients had rised.MH developed more often in general surgery,thopedic surgery and neurosurgery.The first clinical manifestation was the ascensus of the end-tidal CO2（Et-CO2）.Vitro contracture test,which was the gold standard of MH,hadn＇t been generalized yet.CRRT（continus renal replacement treatment） was the newest brightened dot in treatment of MH.The death rate of MH had decreased.Conclusion The report of MH and inducing drugs have been increasing,while death rate decrease.Our country＇s monitoring system and diagnosis of MH still needs to be consummated as soon as possible.The vitro contracture test,dynamic monitoring of lactic acid and use of dantrolene should be generalized.