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诊断为全身麻醉后恶性高热患者的治疗和护理:一例报告。

Treatment and nursing care of a patient diagnosed with malignant hyperthermia after general anesthesia: a case report.

机构信息

State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, and Postanesthesia Care Unit; West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.

出版信息

J Int Med Res. 2024 Jun;52(6):3000605241261962. doi: 10.1177/03000605241261962.

Abstract

Malignant hyperthermia (MH), characterized by severe myoclonus, pyrexia, tachycardia, hypertension, elevated muscle enzymes, and hypercapnia, often occurs in patients with congenital deformities or genetic disorders. Although the reported incidence rate is as low as 1:5000 to 1:100,000, patients with MH exhibit rapid aggravation and an elevated mortality rate. Thus, MH is associated with substantial perioperative risk. Successful treatment of patients with MH largely depends on early diagnosis and timely effective treatment. This clinical report provides a detailed description of a patient with newly diagnosed MH who developed a rapid rise in body temperature, end-tidal carbon dioxide, and heart rate during maxillary osteotomy. After successful rescue, the patient recovered smoothly during the postoperative period, indicating the importance of intraoperative monitoring, early diagnosis, effective treatment, and postoperative monitoring. This case is expected to serve as a reference for future interventions and healthcare practices in managing other patients with MH.

摘要

恶性高热(MH)以严重的肌阵挛、发热、心动过速、高血压、肌肉酶升高和高碳酸血症为特征,常发生在先天性畸形或遗传疾病患者中。尽管报道的发病率低至 1:5000 至 1:100000,但 MH 患者病情迅速恶化,死亡率较高。因此,MH 与围手术期风险密切相关。成功治疗 MH 患者在很大程度上取决于早期诊断和及时有效的治疗。本临床报告详细描述了 1 例新诊断为 MH 的患者,在进行上颌骨切开术时体温、呼气末二氧化碳和心率迅速升高。成功抢救后,患者术后恢复顺利,提示术中监测、早期诊断、有效治疗和术后监测的重要性。该病例有望为未来管理其他 MH 患者的干预措施和医疗保健实践提供参考。

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