运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习

doi:10.3969/j.issn.1004-583X.2022.09.013

临床荟萃 ›› 2022, Vol. 37 ›› Issue (9): 831-833.doi: 10.3969/j.issn.1004-583X.2022.09.013

运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习

刘向东^1a, 蔡延东^1a, 秦延军^1b, 李云松^1a, 李亮^1a, 高瑞姣^1a, 任磊², 张彦荣^1a()

1.河北医科大学第三医院 a.血管外科;b.急诊科, 河北石家庄 050051
2.临西县人民医院麻醉科,河北邢台 054900

收稿日期:2022-02-08 出版日期:2022-09-20 发布日期:2022-11-21
通讯作者: 张彦荣 E-mail:zhangyanrong3320@163.com
基金资助:
河北省医学科学研究计划项目——新型抗凝药物联合血管腔内治疗下肢血管疾病的临床效果(20200982);河北省政府资助专科带头人培养项目——下腔静脉滤器在下肢深静脉血栓治疗中的应用研究(201836100512)

Exertional rhabdomyolysis complicated with acute renal insufficiency and catheter-related thrombosis: One case and literature review

Liu Xiangdong^1a, Cai Yandong^1a, Qin Yanjun^1b, Li Yunsong^1a, Li Liang^1a, Gao Ruijiao^1a, Ren Lei², Zhang Yanrong^1a()

1a. Department of Vascular Surgery, 1b. Department of Emergency, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
2. Department of Anesthesiology, Linxi County People's Hospital, Xingtai 054900, China

Received:2022-02-08 Online:2022-09-20 Published:2022-11-21
Contact: Zhang Yanrong E-mail:zhangyanrong3320@163.com

摘要/Abstract

摘要：

目的探讨多学科联合治疗运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓的临床效果。方法选取河北医科大学第三医院急诊科与血管外科联合治疗的运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓的患者1例, 对其临床资料、治疗方案进行回顾性分析, 评价临床治疗效果。结果急诊科采用血液透析治疗急性肾功能不全,血管外科采用清除血栓术治疗透析管相关性血栓形成,患者痊愈出院。结论本例患者经多学科联合治疗取得了良好的临床效果。

关键词: 横纹肌溶解, 急性肾功能不全, 透析管相关性血栓形成

Abstract:

Objective To explore the clinical effect of the multidisciplinary combination in treatment of exertional rhabdomyolysis (ER) complicated with acute renal insufficiency (ARI) and catheter-related thrombosis (CRT). Methods A retrospective analysis was conduted in one ER patient complicated by ARI and CRT who visited Department of Emergency and Department of Vascular Surgery, the Third Hospital of Hebei Medical University. The clinical data and treatment plan were analyzed to evaluate the clinical treatment effect.Results Hemodialysis was used for ARI in the Department of Emergency, thrombectomy was performed to treat CRT in the Department of Vascular Surgery. The patient recovered and was discharged from the hospital.Conclusion This patient has achieved good clinical outcome through multidisciplinary combination therapy.

Key words: rhabdomyolysis, acute renal insufficiency, dialysis tube-related thrombosis

中图分类号:

R685.5

刘向东, 蔡延东, 秦延军, 李云松, 李亮, 高瑞姣, 任磊, 张彦荣. 运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习[J]. 临床荟萃, 2022, 37(9): 831-833.

Liu Xiangdong, Cai Yandong, Qin Yanjun, Li Yunsong, Li Liang, Gao Ruijiao, Ren Lei, Zhang Yanrong. Exertional rhabdomyolysis complicated with acute renal insufficiency and catheter-related thrombosis: One case and literature review[J]. Clinical Focus, 2022, 37(9): 831-833.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.09.013

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I9/831

图/表 3

图1 治疗期间各指标变化趋势 a.CK:治疗拐点在2021-5-18,接近正常值在2021-5-22; b. LDH:治疗拐点在2021-5-17,接近正常值在2021-5-20; c. 血清MB:治疗拐点在2021-5-22,接近正常值在2021-5-26;d. D-Dimer:治疗拐点在2021-5-17,接近正常值在2021-5-20

图2 下腔静脉造影显示滤器内上部及下部:箭头所指为拦截血栓

图3 经滤器回收导管吸出体外的变形血栓

参考文献 10

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运动性横纹肌溶解症并发急性肾功能不全及透析管相关性血栓1例并文献复习

Exertional rhabdomyolysis complicated with acute renal insufficiency and catheter-related thrombosis: One case and literature review

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