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挤压综合征的病理生理学与管理:一篇叙述性综述。

Pathophysiology and management of crush syndrome: A narrative review.

作者信息

Khan Shahnawaz, Neradi Deepak, Unnava Nikhil, Jain Mantu, Tripathy Sujit Kumar

机构信息

Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar 751019, India.

出版信息

World J Orthop. 2025 Apr 18;16(4):104489. doi: 10.5312/wjo.v16.i4.104489.

Abstract

BACKGROUND

Crush syndrome refers to the traumatic rhabdomyolysis leading to a spectrum of disorders culminating in acute kidney injury. The burden of crush syndrome is high, and mortality can be as high as 20%. The significant bulk of knowledge is from old articles. Over the last 10 years new research has occurred on diagnosis and treatment in animal models.

AIM

To overview of crush syndrome and discuss the newer advances related to the pathogenesis and management of a patient with crush syndrome.

METHODS

The search of databases such as MEDLINE, Google Scholar, Web of Science, and EMBASE revealed 8226 articles. A thorough screening culminated in 83 crush syndrome articles included in this study.

RESULTS

Acute kidney injury in crush syndrome is currently thought to be due to iron retention. The management of crush syndrome has also been updated with antioxidants, and several gases are being used to treat crush syndrome. In the end, treatment of crush syndrome also includes mental, social, and physical rehabilitation for better outcomes.

CONCLUSION

The outcomes of crush syndrome have significantly improved with the introduction of newer treatment modalities, including antioxidants, hyperbaric oxygen therapy, and comprehensive mental, social, and physical rehabilitation.

摘要

背景

挤压综合征是指创伤性横纹肌溶解导致一系列疾病,最终发展为急性肾损伤。挤压综合征的负担很重,死亡率可高达20%。大部分知识来自旧文章。在过去10年里,动物模型的诊断和治疗方面出现了新的研究。

目的

概述挤压综合征,并讨论与挤压综合征患者发病机制和管理相关的最新进展。

方法

检索MEDLINE、谷歌学术、科学网和EMBASE等数据库,共检索到8226篇文章。经过全面筛选,最终纳入本研究的挤压综合征文章有83篇。

结果

目前认为挤压综合征中的急性肾损伤是由于铁潴留所致。挤压综合征的管理也已更新,采用了抗氧化剂,并且几种气体正用于治疗挤压综合征。最后,挤压综合征的治疗还包括心理、社会和身体康复,以获得更好的治疗效果。

结论

随着包括抗氧化剂、高压氧治疗以及全面的心理、社会和身体康复等新治疗方式的引入,挤压综合征的治疗效果有了显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/477c/12019140/37f53b41cb21/104489-g001.jpg

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