Gómez M, Castañeda M, Araujo A M, Pascual J, Martín M P, Batllori M
Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de Navarra, Pamplona.
An Sist Sanit Navar. 2006 Jan-Apr;29(1):131-5. doi: 10.4321/s1137-66272006000100013.
Compartment syndrome is a condition in which increased pressure within a limited space compromises tissue perfusion with the development of rhabdomyolysis. The causes can be physical, such as the pressure exerted on an anatomical region, or it can be associated with the consumption of illegal drugs, especially heroin. In this latter case, toxic and immunological mechanisms are involved in the physiopathology. Acute renal failure develops in 30% of cases of rhabdomyolysis. Its treatment includes efficient volume replacement, forcing urinary alkalinization and the administering of furosemide and mannitol, with certain precautions. No benefit has been shown in dopamine. When a heroin addict patient shows a clinical pattern of tumescence of his extremities, with or without a period of unconsciousness, the presence of compartment syndrome is to be suspected.
骨筋膜室综合征是一种在有限空间内压力升高,导致横纹肌溶解并损害组织灌注的病症。其病因可能是物理性的,比如对某个解剖区域施加的压力,也可能与非法药物的使用有关,尤其是海洛因。在后一种情况下,生理病理学涉及毒性和免疫机制。30%的横纹肌溶解病例会发展为急性肾衰竭。其治疗包括有效的容量补充、强制尿液碱化以及使用呋塞米和甘露醇,并采取某些预防措施。多巴胺未显示出有益效果。当海洛因成瘾患者出现肢体肿胀的临床症状,无论有无昏迷期,都应怀疑存在骨筋膜室综合征。