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大面积横纹肌溶解症;肝细胞功能障碍的罕见病因。

Massive Rhabdomyolysis; A Rare Cause of Hepatocellular Dysfunction.

作者信息

Al Manasra Abdel Rahman A, Shattarah Osama K

机构信息

Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Am J Case Rep. 2018 Jan 29;19:105-108. doi: 10.12659/ajcr.906452.

Abstract

BACKGROUND Rhabdomyolysis syndrome is a rare surgical complication. It is infrequently reported in prolonged operations under lateral decubitus position. This syndrome mainly impacts kidney function and electrolytes levels; liver is another organ that is uncommonly affected. CASE REPORT A 54-year-old male underwent a partial hepatectomy in the supine position, the procedure lasted three hours. After five days of uneventful recovery from surgery, he was readmitted to the hospital with rhabdomyolysis syndrome involving his lower limbs. No predisposing factors other than surgery could be identified. Based on blood tests, the only affected organ was the liver. Upon aggressive hydration, the creatinine kinase, hepatic enzymes, bilirubin levels, and prothrombin time were normalized. The patient regained normal physical strength over the next few weeks. CONCLUSIONS Liver dysfunction secondary to rhabdomyolysis is rare but should be considered when other causes are excluded. Prothrombin time, bilirubin levels and albumin levels may help to identify concomitant liver damage. Rhabdomyolysis is rarely reported in liver resection surgeries.

摘要

背景 横纹肌溶解综合征是一种罕见的手术并发症。在侧卧位长时间手术中鲜有报道。该综合征主要影响肾功能和电解质水平;肝脏是另一个较少受影响的器官。病例报告 一名54岁男性在仰卧位接受了部分肝切除术,手术持续了三个小时。术后平稳恢复五天后,他因下肢横纹肌溶解综合征再次入院。除手术外,未发现其他诱发因素。根据血液检查,唯一受影响的器官是肝脏。经过积极补液,肌酸激酶、肝酶、胆红素水平和凝血酶原时间恢复正常。患者在接下来的几周内恢复了正常体力。结论 横纹肌溶解继发的肝功能障碍很少见,但在排除其他原因时应予以考虑。凝血酶原时间、胆红素水平和白蛋白水平可能有助于识别合并的肝损伤。肝切除手术中很少报道横纹肌溶解。

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Rhabdomyolysis and acute kidney injury.横纹肌溶解症与急性肾损伤。
N Engl J Med. 2009 Jul 2;361(1):62-72. doi: 10.1056/NEJMra0801327.
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The syndrome of rhabdomyolysis: complications and treatment.横纹肌溶解综合征:并发症与治疗
Eur J Intern Med. 2008 Dec;19(8):568-74. doi: 10.1016/j.ejim.2007.06.037. Epub 2008 Apr 28.
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Rhabdomyolysis: an evaluation of 475 hospitalized patients.横纹肌溶解症:对475例住院患者的评估
Medicine (Baltimore). 2005 Nov;84(6):377-385. doi: 10.1097/01.md.0000188565.48918.41.
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Increased liver chemistry in an asymptomatic patient.
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