Malin A, Freyhoff J, Nobis W, Bone H G
Klinik für Anästhesiologie und Intensivmedizin, Knappschaftskrankenhaus Recklinghausen, Klinikum Vest GmbH, Deutschland.
Anaesthesist. 2012 Mar;61(3):224-6, 228. doi: 10.1007/s00101-012-1987-3. Epub 2012 Mar 21.
A case report of severe rhabdomyolysis in a 33-year-old motorcyclist after multiple trauma is described. The injuries included severe thoracic and abdominal trauma as well as injuries to the extremities and spinal column. During the first 3 days of treatment a forced volume therapy was performed because of increased levels of creatine kinase during which the patients condition stabilized both hemodynamically and respiratorily. On day 10 the patient developed a rise in temperature to 42°C with no evidence of a re-infection and the creatine kinase levels rose to 109,830 U/l. A continuous hemofiltration was started because of acute renal failure. The creatine kinase levels declined significantly and renal function also returned to normal with adequate diuresis up to day 20. After intensive questioning of the relatives a history of long-term use of anabolic steroids, clenbuterol as well as the intake of testosterone enanthate was conceded. Cocaine and amphetamines were also taken regularly by the patient.
本文描述了一名33岁摩托车手在遭受多处创伤后发生严重横纹肌溶解症的病例报告。损伤包括严重的胸腹部创伤以及四肢和脊柱损伤。在治疗的前3天，由于肌酸激酶水平升高，进行了强制容量治疗，在此期间患者的血流动力学和呼吸状况均稳定。在第10天，患者体温升至42°C，无再次感染迹象，肌酸激酶水平升至109,830 U/l。由于急性肾衰竭，开始进行持续血液滤过。直至第20天，肌酸激酶水平显著下降，肾功能也随着尿量充足恢复正常。在对患者亲属进行深入询问后，患者承认有长期使用合成代谢类固醇、克伦特罗以及摄入庚酸睾酮的病史。患者还经常服用可卡因和苯丙胺。
