急性动脉阻塞导致肌病肾病代谢综合征17例的治疗  

Management of myonephropathic-metabolic syndrome after acute arterial occlusion: report of 17 cases

作　　者：杨德华[1] 胡海地[1] 段志泉[1] 张强[1] 

机构地区：[1]中国医科大学第一临床学院血管外科,沈阳110001

出　　处：《中华普通外科杂志》2002年第1期18-19,共2页Chinese Journal of General Surgery

摘　　要：目的总结急性动脉阻塞致肌病肾病代谢综合征 (myonephropathic metabolicsyndrome,MNMS)的诊治经验。方法回顾性分析 1994年 1月至 2 0 0 1年 3月由急性动脉阻塞导致的MNMS 17例的临床资料。结果 5例存活 ,6例死于高钾血症引起的心搏骤停 ,6例死于急性肾功能衰竭 (a cuterenalfailure ,ARF)为首发的多器官功能不全综合征 (multipleorgandysfunctionsyndrome ,MODS)。死亡率 71% ,截肢率 41%。结论急性动脉阻塞尽快重建血流、骨筋膜室综合征尽早行筋膜室切开术及坏疽肢体尽早截肢是预防和治疗MNMS的关键。早期大量补液、应用碱性药物可预防ARF 。ObjectiveTo investigate the management of myonephropathic-metabolic syndrome (MNMS) after acute arterial occlusion. Methods17 cases of MNMS caused by acute arterial occlusion were restrospectively reviewed. Results5 cases were cured, 6 cases died of sudden cardiac arrest induced by hyperkalemia, and another 6 cases died of multiple organ dysfunction syndrome (MODS) complicated by acute renal failure. The total mortality rate was 71% and the amputation rate was 41%.ConclusionEarly revascularization should be performed in acute arterial occlusion. In patients with compartment syndrome, fasciotomy should be performed as soon as possible. Early amputation of gangrene limb is very important to prevent MNMS. Early and effective fluid resuscitation and alkalinization is the key point to prevent ARF, early hemodialysis for ARF is very important in treating MNMS.

关 键 词：动脉闭塞性疾病 肌红蛋白尿 血管外科手术 肌病肾病代谢综合征 MNMS 

分 类 号：R654.4[医药卫生—外科学] R692[医药卫生—临床医学]