Oka S, Igarashi Y, Takagi A, Nishida M, Sato K, Nakada K, Ikeda K
Can Anaesth Soc J. 1982 Nov;29(6):627-9. doi: 10.1007/BF03007752.
We report a patient with Duchenne muscular dystrophy who developed malignant hyperpyrexia during general anaesthesia. During anaesthesia bradycardia was followed by ventricular fibrillation, on which ventricular flutter supervened and a body temperature rise of 0.6 degrees C for 15 minutes, myoglobinuria and elevation of CPK level were observed. The caffeine sensitivity test of biopsied muscle fibers revealed an increase in sensitivity, although there was no sign of muscle rigidity during or after anaesthesia. Diagnosis of Duchenne muscular dystrophy was first established after the development of malignant hyperpyrexia in the present case as well as in previously reported cases. Determination of serum CPK is very important before general anaesthesia.
我们报告一例杜氏肌营养不良患者,其在全身麻醉期间发生恶性高热。麻醉期间出现心动过缓,随后发生心室颤动,继之出现心室扑动,体温在15分钟内升高0.6摄氏度,观察到肌红蛋白尿和肌酸磷酸激酶(CPK)水平升高。活检肌纤维的咖啡因敏感性试验显示敏感性增加,尽管麻醉期间及之后均无肌肉强直迹象。在本病例以及先前报道的病例中,均是在发生恶性高热后才首次确诊为杜氏肌营养不良。全身麻醉前测定血清CPK非常重要。