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创伤性横纹肌溶解症后电解质失衡的发生率:一项系统评价和荟萃分析。

Incidence of Electrolyte Imbalances Following Traumatic Rhabdomyolysis: A Systematic Review and Meta-Analysis.

作者信息

Safari Saeed, Aghili Seyed Hadi, Shahlaee Mohammad A, Jamshidi Kerachi Ali, Farhang Ranjbar Mehri

机构信息

Emergency Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IRN.

Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, IRN.

出版信息

Cureus. 2024 Apr 30;16(4):e59333. doi: 10.7759/cureus.59333. eCollection 2024 Apr.

Abstract

Rhabdomyolysis, a medical condition caused by the destruction of striated muscle fibers, can have many etiologies, with the most common one being traumatic etiologies, that is, crushing injuries, heavy exertion, and being trapped under rubbles, and so forth. Rhabdomyolysis causes many complications, including acute kidney injury and different electrolyte imbalances, which later can cause cardiac dysrhythmia and even death as a result. This systematic review and meta-analysis investigate the incidence of imbalances of four important electrolytes among patients diagnosed with traumatic rhabdomyolysis. PubMed, Scopus, Web of Science, and Embase databases were searched for any article related to traumatic rhabdomyolysis using keywords related to the topic of our study, excluding case studies and case series. Relevant data were extracted from the included articles, and finally, a meta-analysis was performed on them to calculate the pooled incidence of each electrolyte imbalance. Collectively, 32 articles were included in our study (through the database and citation checking). The following were the pooled incidence of each electrolyte imbalance: hyperkalemia, 31% (95%CI 22%-41%); hypokalemia, 10% (95%CI 4%-17%); hypernatremia, 3% (95%CI 0%-8%); hyponatremia, 23% (95%CI 7%-44%); hypercalcemia, 0% (95%CI 0%-1%); hypocalcemia, 57% (95%CI: 22%-88%); hyperphosphatemia, 33% (95%CI 11%-59%); hypophosphatemia, 4% (95%CI 0%-16%). According to the meta-analyses, the rate of hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia is higher than their counterpart in patients diagnosed with traumatic rhabdomyolysis.

摘要

横纹肌溶解症是一种由横纹肌纤维破坏引起的病症,其病因众多,最常见的是创伤性病因,即挤压伤、过度劳累以及被困于废墟之下等。横纹肌溶解症会引发多种并发症,包括急性肾损伤和不同程度的电解质失衡,这些并发症随后可能导致心律失常甚至死亡。本系统评价和荟萃分析旨在调查创伤性横纹肌溶解症患者中四种重要电解质失衡的发生率。通过在PubMed、Scopus、科学网和Embase数据库中使用与我们研究主题相关的关键词搜索任何与创伤性横纹肌溶解症相关的文章,排除病例研究和病例系列。从纳入的文章中提取相关数据,最后对其进行荟萃分析以计算每种电解质失衡的合并发生率。我们的研究共纳入32篇文章(通过数据库和引文检查)。以下是每种电解质失衡的合并发生率:高钾血症,31%(95%置信区间22%-41%);低钾血症,10%(95%置信区间4%-17%);高钠血症,3%(95%置信区间0%-8%);低钠血症,23%(95%置信区间7%-44%);高钙血症,0%(95%置信区间0%-1%);低钙血症,57%(95%置信区间:22%-88%);高磷血症,33%(95%置信区间11%-59%);低磷血症,4%(95%置信区间0%-16%)。根据荟萃分析,创伤性横纹肌溶解症患者的高钾血症、低钠血症、低钙血症和高磷血症发生率高于相应的对照情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17c0/11137607/81bb4fc5e174/cureus-0016-00000059333-i01.jpg

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