摘要
目的：對橫紋肌溶解症（rhabdomyolysis, RM）的臨床特點、診斷、治療進行分析後對RM的診治經驗進行總結。方法：對鏡湖醫院最近5年收治13例RM患者，回顧其病因、症狀、相關血指標（CK、CK-MB、LDH、ALT、AST、SCr、UREA）及尿血紅蛋白、尿量等進行總結分析。結果：在13例患者中，病因包括：熱射病、運動健身、肌肉受壓、服用降脂藥。入院時表現為肌肉疼痛及肢體乏力。均有不同程度CK、AST、ALT、LDH升高，7例出現血紅蛋白尿；3例尿量減少。均經過補液及對症治療，並其中4例接受血液淨化治療。治療後症狀、血指標均有不同程度好轉：CK、ALT、LDH下降有意義（P<0.05），其他指標雖有下降，但無意義。結論：RM病因多種，機制也各不相同，臨床表現多以肌肉疼痛乏力、CK明顯升高，可伴發AKI發生，治療主要為足量補液、保證水電穩定，若伴發AKI、嚴重高鉀血症及多器官損傷則需要血液淨化治療，經過治療後大多患者預後良好。
並列摘要
Objective: To analyze the clinical features, diagnosis and treatment of rhabdomyolysis (RM) and case-based experiences. Methods: 13 cases of rhabdomyolysis admitted in the past 5 years were retrospectively studied for their etiology, symptoms, blood tests, urine hemoglobin and urine output. Results: The etiological causes of the 13 cases included heat stroke (7.69%), exercises (30.77%), muscle compression (38.46%) and lipid-lowering agents use (23.07%). Muscle pain and fatigue with elevated CK, AST, ALT, LDH were observed in all patients upon admission, whereas hemoglobinuria occurred in 7 cases and oliguria in 3 cases. All cases received intravenous fluid infusion and symptomatic treatment, 4 cases underwent blood purification. Symptoms and laboratory test results improved in all patients after treatment; CK, ALT, LDH significantly decreased (P<0.05), other biomarkers decreased without statistical significance. Conclusion: Rhabdomyolysis is a multifactorial syndrome with complex pathogenesis. Clinical presentation includes muscle pain, fatigue, elevated CK, and possibly AKI. Treatment mainly relies on sufficient fluid infusion in order to maintain fluid and electrolyte homeostasis. Blood purification should be considered in case of AKI, severe hyperkalemia and multiple organ dysfunctions. The majority of the cases showed clinical improved with favorable prognosisafter treatment.