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- Rhabdomyolysis after a Long-term Thoracic Surgery in Right Decubitus Position
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題名 | Rhabdomyolysis after a Long-term Thoracic Surgery in Right Decubitus Position=病患以右側位姿勢接受左上肺葉切除術於術後產生橫紋肌溶解症之病例報告 |
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作者 | 孔祥珣; 何善臺; 黃國巡; 鄭澄寰; 汪志雄; Kong, Shang-shung; Ho, Shung-tai; Huang, Go-shine; Cherng, Chen-hwan; Wong, Chih-shung; |
期刊 | 麻醉學雜誌 |
出版日期 | 20001200 |
卷期 | 38:4 2000.12[民89.12] |
頁次 | 頁223-228 |
分類號 | 416.224、416.224 |
語文 | eng |
關鍵詞 | 橫紋肌溶解症; 姿勢; 急性腎衰竭; Rhabdomyolysis; Kidney failure:Acute; Posture; |
中文摘要 | 我們報告一罕見案例,因肺部左上葉腺癌以右側位姿勢接受為期約十小時之手術,手術過程順利,病患於術後次日在外科加護中心發現產生橫紋肌溶解症。追查其原因可能為病患腰部、臀部及大腿肌肉長時間接受直接來自於手術檯面之作用力,因而造成肌肉的間室壓力上昇繼而可能產生血流再灌注性傷害所致。錄病患有橫紋肌溶解症之病徵時,須立即探取大量輸液、鹼化尿液及利尿劑治療以預防進一步之腎功能衰竭。先期發現危險因子時,應探取預防措施,而早期診斷及治療為成功恢腹正常之關鍵。 |
英文摘要 | We report a rare case who developed rhabdomyolysis associated with the use of the tight decubitus position for 10 h during thoracotomy with lobectomy. It appears that an increasing of the compartment pressure may induce reperfusion injury of the ischemic muscle by prolonged compression of the gluteal and flank muscles against the operation table. Early recognition and aggressive treatment with intravenous fluid and diuresis may prevent the development of acute renal failure. Adequate prevention in high-risk patients, early diagnosis and aggressive treatment are the keys to a successful recovery. |
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