目的 总结急性动脉栓塞致肌病肾病代谢综合征(myonephropathic-metabolic syndrome,MNMS)的诊治经验。
方法 回顾性分析2005年1月至2006年3月由急性动脉栓塞导致的11例MNMS的临床资料。
结果 5例存活(保肢4例); 2例死于高钾血症引起的心搏骤停,4例死于以急性肾功能衰竭为首发的多器官功能不全综合征。
结论 急性动脉栓塞一旦确诊,尽早手术。MNMS是急性动脉栓塞的常见、严重并发症,急性动脉栓塞时尽快重建血流、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。
Citation:
万嘉,时德,罗开元,杨镛,杨国凯,何晓明. Treatment of Myonephropathic-Metabolic Syndrome Caused by Acute Arterial Embolism. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(6): 701-702. doi:
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Urayama H, Harada T, Kawasuji M, et al. Immediate haemodialysis and staged fasciotomy in the treatment of reperfusion injury [J]. Cardiovasc Surg, 1994; 2(4)∶519.
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David WS. Myoglobinuria [J]. Neurol Clin, 2000; 18(1)∶215.
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Nicolau D, Feng YS, Wu AH, et al. Myoglobin clearance during continuous veno-venous hemofiltration with or without dialysis [J]. Int J Artif Organs, 1998; 21(4)∶205.
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Ronco C, Bellomo R, Homel P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial[J]. Lancet, 2000; 356(9223)∶26.
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- 1. Haimovici H. Arterial embolism with acute massive ischemic myopathy and myoglobinuria: evaluation of a hitherto unreported syndrome with report of two cases [J]. Surgery, 1960; 47∶739.
- 2. Haimovici H. Muscular, renal, and metabolic complications of acute arterial occlusions: myonephropathic-metabolic syndrome [J]. Surgery, 1979; 85(4)∶461.
- 3. 釘公敏定, 高木正剛. 急性動脈閉塞の代謝性合併症(MNMS)[J]. 日本醫事新報, 1990; 3459(12)∶23.
- 4. Littooy FN, Baker WH. Acute aortic occlusion——a multifaceted catastrophe [J]. J Vasc Surg, 1986; 4(3)∶211.
- 5. 段志泉, 张强主编. 实用血管外科学 [M]. 第1版. 沈阳: 辽宁科学技术出版社, 1999∶256~261.
- 6. Magnoni F, Pedrini L, Palumbo N, et al. Ischemia: reperfusion syndrome of the lower limbs [J]. Int Angiol, 1996; 15(4)∶350.
- 7. Urayama H, Harada T, Kawasuji M, et al. Immediate haemodialysis and staged fasciotomy in the treatment of reperfusion injury [J]. Cardiovasc Surg, 1994; 2(4)∶519.
- 8. David WS. Myoglobinuria [J]. Neurol Clin, 2000; 18(1)∶215.
- 9. Nicolau D, Feng YS, Wu AH, et al. Myoglobin clearance during continuous veno-venous hemofiltration with or without dialysis [J]. Int J Artif Organs, 1998; 21(4)∶205.
- 10. Ronco C, Bellomo R, Homel P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial[J]. Lancet, 2000; 356(9223)∶26.
- 11. Gilbert RW. Blood flow rate effects in continuous venovenous hemodiafiltration on blood urea nitrogen and creatinine reduction[J]. Nephrol Nurs J, 2000; 27(5)∶503.
- 12. 师天雄, 郭天雄, 汪忠镐. 代谢性肌肾综合征[J]. 国外医学·外科学分册, 1995; 22(5)∶258.