挤压综合征
横纹肌溶解症
复苏
医学
肌酸激酶
多器官功能障碍综合征
挤压伤
内科学
外科
败血症
作者
Takeshi Shimazu,Toshiharu Yoshioka,Yasuki Nakata,Kazuo Ishikawa,Yasuaki Mizushima,Fumio Morimoto,Masashi Kishi,Makoto Takaoka,Hiroshi Tanaka,Atsushi Iwai,Atsushi Hiraide
出处
期刊:Journal of Trauma-injury Infection and Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:1997-04-01
卷期号:42 (4): 641-646
被引量:86
标识
DOI:10.1097/00005373-199704000-00010
摘要
Crush syndrome is a form of traumatic rhabdomyolysis characterized by systemic involvement, in which acute renal failure is potentially life-threatening.Clinical and laboratory data of 14 crush-syndrome patients transferred to a tertiary emergency department after the Hanshin-Awaji earthquake were analyzed. The patients were buried under collapsed houses for the average of 6.7 +/- 5.7 (SD) hours (range, 1 to 24 hours). They were referred to us 6 to 250 hours after the earthquake.Of those who arrived at our institution within 40 hours, 25% (two of eight) developed renal failure, whereas all six patients who arrived after 40 hours developed renal failure. Peak serum creatine kinase ranged from 6,677 to 134,200 U/L (51,674 +/- 41,776). Renal failure was highly associated with massive muscle damage (serum creatine kinase above 25,000 U/L) and insufficient initial fluid resuscitation (below 10,000 mL/2 days).Prompt and adequate, if not massive, fluid resuscitation is the key to preventing renal failure after such injury.
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