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頁籤選單縮合
題名 | Rhabdomyolysis-Induced Acute Renal Failure after Morphine Overdose--A Case Report=服用過量嗎啡導致橫紋肌溶解及急性腎衰竭 |
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作者 | 沈靜慧; 洪至仁; 吳志成; 黃惠文; 何謂明; Shen, Ching-hui; Hung, Chih-jen; Wu, Chin-cheng; Huang, Hui-wein; Ho, Wai-meng; |
期刊 | 麻醉學雜誌 |
出版日期 | 19990900 |
卷期 | 37:3 1999.09[民88.09] |
頁次 | 頁159-162 |
分類號 | 416.5 |
語文 | eng |
關鍵詞 | 嗎啡; 急性腎衰竭; 橫紋肌溶解; Morphine; Kidney failure; Acute; Rhabdomyolysis; |
中文摘要 | 患者是一位三十九歲男性,頸椎脊髓損傷已有七年之久。自1995年起,他持續於 疼病料及精神科追蹤並以嗎啡、抗癲癇藥物,和些許安眠藥來治療他酌慢性疼痛。在這次住 院之前,處方藥物為嗎啡每四小時服用20毫克及睡前服用Baclofen5亳克。1997年12月15 日晚上,病患服 用約0.1克嗎啡及若干粒Baclofen。次日,病人開始覺得雙腳麻痺、大腿 疼痛腫脹。住院後發現急性肌肉損害及血中肌氨酸、肌氨酸□值升高,尿中有肌球素形成, 而且併發急性腎衰竭,尿中嗎啡濃度高達6,384ng/mL。肌肉掃瞄顯示兩側大腿近端PYP吸收 增加。經給予洗腎、大量水份並鹼化尿液治療,兩週後,前述異常漸漸消退,病人腎功能完 全恢復。 |
英文摘要 | The 39-year-old male in this report was a victim of C4 spinal cord injury for 7 years. He was regularly followed up at our pain clinic and psychiatric out-patient department (OPD) for treatment of his chronic pain with morphine, anriconvulsant and sedatives. At the night of December 15, 1997, he took approximately 0.1 gm of morphine and a certain number of flurazepam pills. On the next day, he experienced numbness and paresis in both legs in association with painful swelling of both thighs. Then he sought medical advice at our hospital and was admitted for investigation on December 20, 1997. Laboratory examination revealed elevated creatine kinase activity, increased urine myoglobin concentration and raised plasma creatinine, signifying the development of acute muscle damage. The excreted urine morphine concentration was as high as 6,384 ng/mL. Increased PYP uptake in the proximal portion of both thighs was noted on muscle scan. These abnormalities were resolved gradually over two weeks under conservative treatment. Morphine-induced rhabdomyolysis complicated by acute renal failure was highly suspected. |
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