Zidouh Ali, Tebib Tarek, Salmi Othmane, Mourouth Hanane, Ziadi Amra
Anesthesiology, Intensive Care and Emergency Department, University Hospital Mohammed VI of Marrakesh, Marrakesh, Morocco.
Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh, Morocco.
Oxf Med Case Reports. 2025 Jan 18;2025(1):omae175. doi: 10.1093/omcr/omae175. eCollection 2025 Jan.
Crush trauma of extremities, resulting from a crushing force, can be life-threatening even without involving vital organs. Crush syndrome, or traumatic rhabdomyolysis, occurs when muscle cell breakdown releases contents into the bloodstream, leading to systemic complications like acute renal failure. A 35-year-old woman trapped under rubble during11 hours during a seismic event, presenting with compartment syndrome in her left arm and thigh and crush syndrome. Emergent fasciotomy and aggressive fluid resuscitation were performed, preventing renal failure and metabolic derangement. Post-fasciotomy, pulses returned to her affected limbs. She was extubated and moved to the ICU under close surgical supervision. Early, aggressive resuscitation is critical, ideally before extrication, to minimize complications. Awareness of hyperkalemia and acute renal failure risk post-extrication is essential. Continuous fluid resuscitation is the cornerstone of treatment, and prompt fasciotomies are crucial for compartment syndrome management.
肢体挤压伤是由挤压力量导致的,即使不涉及重要器官也可能危及生命。挤压综合征,即创伤性横纹肌溶解症,当肌肉细胞分解并将内容物释放到血液中时就会发生,从而导致诸如急性肾衰竭等全身并发症。一名35岁女性在一次地震事件中被困在废墟下11个小时,出现了左臂和大腿的骨筋膜室综合征以及挤压综合征。紧急进行了筋膜切开术并积极进行液体复苏,预防了肾衰竭和代谢紊乱。筋膜切开术后,她患侧肢体恢复了脉搏。她被拔除气管插管,并在严密的外科监护下转入重症监护病房。早期积极的复苏至关重要,理想情况是在解救之前进行,以尽量减少并发症。了解解救后高钾血症和急性肾衰竭的风险至关重要。持续的液体复苏是治疗的基石,及时的筋膜切开术对于骨筋膜室综合征的处理至关重要。