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三例恶性高热的临床治疗

Clinical treatment of malignant hyperthermia in three cases.

作者信息

Pan Tao, Ji Wenli, Nie Mengqi, Li Yang

机构信息

Department of Intensive Care Medicine, Xiangyang Hospital Affiliated to Hubei University of Medicine, Wuhan, Hubei 441000, P.R. China.

出版信息

Exp Ther Med. 2016 Nov;12(5):2881-2884. doi: 10.3892/etm.2016.3712. Epub 2016 Sep 16.

Abstract

Malignant hyperthermia (MH) is a rare life threatening inherited disorder that is triggered by drugs used for general anesthesia in susceptible persons. The symptoms include rapid increase of body temperature and severe muscle contractions. The present study includes 3 cases of MH and highlights the timely identification of symptoms for rescuing the patient. In case I, a 7-year-old male child underwent surgery with ketamine at a dose of 250 mg. After 4 h of operation, the child went through convulsions, high fever and succumbed within a few hours. High fever was not detected in a timely manner, which is one of the main symptoms of MH. In case II, a 12-year-old male child had convulsions and high fever after simple surgery caused by MH. Once confirmed, immediate measures were taken to lower the body temperature and the child was rescued. In case III, a male 57-year-old was admitted to hospital due to paraplegia. The patient underwent more critical conditions once symptoms of MH appeared. Additionally, antidote dantrolene was unavailable in the first and third case; thus, the progression of disease was not alleviated although active symptomatic and supportive treatment were employed.

摘要

恶性高热(MH)是一种罕见的、危及生命的遗传性疾病,在易感人群中由全身麻醉用药引发。症状包括体温迅速升高和严重的肌肉收缩。本研究包含3例恶性高热病例,并强调了及时识别症状对抢救患者的重要性。病例一,一名7岁男童接受了250毫克剂量氯胺酮的手术。术后4小时,该儿童出现惊厥、高热,并在数小时内死亡。高热未被及时发现,而高热是恶性高热的主要症状之一。病例二,一名12岁男童在因恶性高热导致的简单手术后出现惊厥和高热。一经确诊,立即采取措施降低体温,该儿童获救。病例三,一名57岁男性因截瘫入院。该患者一旦出现恶性高热症状,病情便更为危急。此外,在第一和第三个病例中无法获得解毒剂丹曲林;因此,尽管采取了积极的对症和支持治疗,但疾病进展并未得到缓解。

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