不用丹曲林成功治疗恶性高热--病例报告

Jyoti Nara, Naveen Yalla
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摘要

恶性高热(MH)是一种罕见的遗传性疾病,在全身麻醉的情况下会导致危及生命的灾难性后果。在印度,由于缺乏报告,报告的病例总数仅为个位数。由于引入了丹曲林钠用于治疗 MH、使用毛细血管造影早期发现 MH 病例,以及引入了 MH 诊断测试,MH 的死亡率从 70-80% 大幅下降到 5%以下。此外,在印度,丹曲林(dantrolene)这种首选药物并不是随处都能买到。在边缘地区,基本监测技术的匮乏不容忽视。尽管存在这些局限性,但通过警惕性监测、及时诊断和积极的支持性治疗,许多报告的病例都得以存活。
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Successful management of malignant hyperthermia without dantrolene – A case report
Malignant hyperthermia (MH) is a rare inherited genetic disorder implicated in a life-threatening catastrophic event under general anaesthesia. In India, the total number of reported cases are of the magnitude of single digit due to lack of reporting. The mortality of MH is dramatically decreased from 70-80% to less than 5%, due to an introduction of dantrolene sodium for treatment of MH, early detection of MH episode using capnography, and the introduction of diagnostic testing for MH.In India, there is enormous dependence on clinical grading scale rather than halothane caffeine contraction test due to the lack of availability of accredited testing facilities. In addition to this, the drug of choice dantrolene, is not readily available everywhere in India. The scarcity of quintessential monitoring techniques cannot be ignored in peripheral areas. Despite these limitations many reported cases have survived with vigilant monitoring, prompt diagnosis and aggressive supportive care.
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