可能被海蛇咬伤后出现严重横纹肌溶解症:病例报告

Pavithera Packiyarajah, Umakanth Maheshwaran, M. Nusair
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摘要

横纹肌溶解症是一种可能危及生命的疾病,其特点是肌肉坏死和肌肉成分释放到血液循环中。横纹肌溶解症有多种病因,但其中许多病因都很复杂或不明确。横纹肌溶解可导致急性肾损伤(AKI)、电解质异常、隔室综合征和弥散性血管内凝血(DIC)等并发症。在我们的病例中,一名 38 岁的男子在游览马纳尔湾时可能被海蛇咬伤,随后出现全身浮肿、身体疼痛和深色尿液。血液检查显示肌酸磷酸激酶(CPK)明显升高。经过适当的补水和碱性利尿,患者没有发生 AKI 或电解质失衡,两周后出院,CPK 明显下降,临床症状也有所改善。
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Severe rhabdomyolysis following a possible sea snake bite: A case report
Rhabdomyolysis is a potentially life-threatening condition characterized by muscle necrosis and the release of muscle constituents into the circulation. Rhabdomyolysis has several causes, however many of them are complex or ambiguous. Rhabdomyolysis can lead to complications such as acute kidney injury AKI), electrolyte abnormalities, compartment syndrome, and disseminated intravascular coagulation (DIC). The main stray of management principle is the prevention of acute kidney injury by hydration, alkalization and diuresis, with correction of electrolyte imbalances and acidosis.In our case, a 38-year-old man presented with generalized body swelling, body pain and dark urine after a possible sea snake bite when he visited Mannar Gulf. Blood workup showed significantly elevated creatinine phosphokinase (CPK). With proper hydration and alkaline diuresis, the patient did not develop AKI or electrolyte imbalances and he was discharged after 2 weeks with a significant reduction in CPK and clinical improvement.
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