尸僵加速1例

D. Krishtafor, O. Pylypenko, A.Y. Halushchak, I.O. Putko
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引用次数: 0

摘要

介绍。尸僵是死后发生的骨骼和平滑肌的紧张,使身体固定在一定的位置。这是生物死亡的征兆之一,通常在1.5 - 3小时内发生,从下颚开始。在死后12 - 24小时内观察到尸僵的完全发育。但在极少数情况下,它的发展可以显著加快。临床病例。34岁男性,在麻醉科和重症监护室住了4天,诊断为爆炸性创伤,颈部损伤伴右颈动脉损伤,半球缺血性中风。在多器官衰竭、中度昏迷、中枢性高热(40.3°C)、对退烧药耐药的情况下,患者发生心脏骤停。复苏措施(包括三次除颤)50分钟无效。在确定生物死亡时,在下颚、颈部和四肢都发现了尸僵,而在复苏的前30分钟和心脏停止节律开始时,尸僵是不存在的。讨论。尸僵的发生可以解释为肌细胞钙离子的释放和肌肉三磷酸腺苷的消耗,导致肌动蛋白和肌球蛋白之间形成稳定的结合。立即或加速尸僵是罕见的。根据文献,高体温、死前剧烈运动、电击、抽搐和肌肉萎缩会加速尸僵。结论。在我们的病例中,患者有严重的高热(40.3°C),在复苏期间进行了除颤,即身体暴露于电流中。这些因素可能导致尸僵的加速发展。
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A CASE OF ACCELERATED RIGOR MORTIS
Introduction. Rigor mortis is the tension of skeletal and smooth muscles that occurs after death and fixes the body in a certain position. It is one of the signs of biological death and usually develops in 1.5 - 3 hours, starting from the lower jaw. The full development of rigor mortis is observed in 12 - 24 hours after death. But in rare cases, its development can be significantly accelerated. Clinical case. A 34-year-old man was in the department of anesthesiology and intensive care for 4 days with a diagnosis of explosive trauma, neck injury with damage to the right carotid artery, hemispheric ischemic stroke. In the setting of multiple organ failure, moderate coma, central hyperthermia (40.3 °C), resistant to antipyretics, he went into a cardiac arrest. Resuscitation measures (including triple defibrillation) for 50 minutes were without effect. During the ascertainment of biological death, the presence of rigor mortis was noted in the lower jaw, neck and extremities, which was absent during the first 30 minutes of resuscitation and at the beginning of the asystolic rhythm. Discussion. The occurrence of rigor mortis is explained by the release of calcium ions from myocytes and the depletion of muscle adenosine triphosphate, which leads to the formation of a stable bond between actin and myosin. Instant or accelerated rigor mortis is rare. According to the literature, high body temperature, strenuous exercise before death, electric shock, convulsions and muscular dystrophy contribute to the acceleration of rigor mortis. Conclusions. In our case, the patient had severe hyperthermia (40.3 ° C), and defibrillation was performed during resuscitation, ie the body was exposed to electric current. Probably, these factors caused the accelerated development of rigor mortis.
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来源期刊
CiteScore
0.10
自引率
0.00%
发文量
34
审稿时长
12 weeks
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