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[恶性高热——牙科手术中的问题。一份初步报告]

[Malignant hyperthermia - problem in dental surgery. An introductory report].

作者信息

Kamińska Ewa, Janas Anna, Osica Piotr

机构信息

Zakład Chirurgii Stomatologicznej UM w Łodzi, ul. Pomorska 251, 92-213 Łódź, Polska, tel.: (42) 675-75-29, 692-607-174, e-mail:

出版信息

Dev Period Med. 2014 Oct-Dec;18(4):483-8.

Abstract

Malignant hyperthermia is a genetic defect of uncontrolled hypermetabolic skeletal muscle response to anesthetic triggering drugs. Some congenital myopathies are regarded as risk increasing factors. The use of volatile anaesthetics or suxamethonium (succinylcholine) in patients who are predisposed to malignant hyperthermia leads to an increase in Ca2+ release from sarcoplasmic reticulum, which in turn causes a set of biochemical and clinical symptoms, which can be a cause of death, if dantrolene is not administered adequately. The aim of the study was to draw attention to the problem of malignant hyperthermia, which is hardly ever described in Polish literature, and requires the necessity of intensifying the cooperation between the dentist and specialists from other medical fields. The origin of the article was a case of congenital myopathy with recognized malignant hyperthermia in an 18-year-old patient, in whom surgical extraction of teeth was indicated. The course of diagnostics and treatment showed once more that contemporary medicine is in need of holistic approach, and in consequence, promising and effective cooperation of many specialists.

摘要

恶性高热是一种遗传性缺陷,表现为骨骼肌对麻醉触发药物产生不受控制的高代谢反应。一些先天性肌病被视为风险增加因素。在易患恶性高热的患者中使用挥发性麻醉剂或琥珀酰胆碱会导致肌浆网释放的Ca2+增加,进而引发一系列生化和临床症状,如果不充分给予丹曲林,这些症状可能会导致死亡。本研究的目的是引起人们对恶性高热问题的关注,该问题在波兰文献中鲜有描述,并且需要加强牙医与其他医学领域专家之间的合作。本文源于一例18岁先天性肌病合并确诊恶性高热的患者病例,该患者需要进行牙齿外科拔除术。诊断和治疗过程再次表明,当代医学需要整体方法,因此需要众多专家进行有前景且有效的合作。

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