Migita Takako, Mukaida Keiko, Kawamoto Masashi, Kobayashi Masako, Yuge Osafumi
Department of Anesthesiology and Critical Care, Hiroshima University Hospital, 1-2-3 Kasumi, Hiroshima 734-8551, Japan.
J Anesth. 2007;21(2):285-8. doi: 10.1007/s00540-006-0495-5. Epub 2007 May 30.
We investigated the transition of clinical signs of fulminant-type malignant hyperthermia (f-MH) by analyzing a database consisting of 383 cumulative cases of f-MH from 1961 to 2004. The cases were divided by time period into group 1 (1961-1984), group 2 (1985-1994), and group 3 (1995-2004). The variables considered were age, sex, type of agents used (succinylcholine and volatile anesthetics), dantrolene administration, clinical signs, laboratory data, and mortality. The level of statistical significance was considered to be less than 5%. Groups 1, 2, and 3 consisted of 196, 127, and 60 cases, respectively. In groups 1, 2, and 3, the rates of dantrolene administration were 18.4%, 93.6%, and 86.7%; the rates of occurrence of ventricular arrhythmia were: 75.2%, 55.6%, and 35.0%; and the rates of generalized muscle rigidity were 64.7%, 60.9%, and 23.9%, respectively. The mortality rate decreased over time, from 42.3% in group 1, to 15.0% in group 2 and group 3. We considered that this decrease occurred because of the increased use of dantrolene and the early diagnosis of malignant hyperthermia in the latter two groups.
我们通过分析一个包含1961年至2004年383例暴发型恶性高热（f-MH）累积病例的数据库，研究了暴发型恶性高热临床症状的转变情况。这些病例按时间段分为第1组（1961 - 1984年）、第2组（1985 - 1994年）和第3组（1995 - 2004年）。所考虑的变量包括年龄、性别、使用的药物类型（琥珀酰胆碱和挥发性麻醉剂）、丹曲林的使用情况、临床症状、实验室数据以及死亡率。统计学显著性水平设定为小于5%。第1组、第2组和第3组分别由196例、127例和60例病例组成。在第1组、第2组和第3组中，丹曲林的使用率分别为18.4%、93.6%和86.7%；室性心律失常的发生率分别为75.2%、55.6%和35.0%；全身肌肉强直的发生率分别为64.7%、60.9%和23.9%。死亡率随时间下降，从第1组的42.3%降至第2组和第3组的15.0%。我们认为这种下降是由于后两组中丹曲林使用的增加以及恶性高热的早期诊断。
