宫颈癌腹腔镜手术后横纹肌溶解症一例诊治体会

doi:10.12280/gjfckx.20220374

国际妇产科学杂志 ›› 2023, Vol. 50 ›› Issue (2): 234-236.doi: 10.12280/gjfckx.20220374

• 妇科肿瘤研究:病例报告 • 上一篇下一篇

宫颈癌腹腔镜手术后横纹肌溶解症一例诊治体会

李娟, 许晓英, 盛燕楠, 马福堂, 赵雅琴, 王芳, 吴珍珍()

730050 兰州，甘肃省妇幼保健院（李娟，许晓英，盛燕楠，马福堂，赵雅琴，王芳，吴珍珍）；甘肃中医药大学第一临床医学院（许晓英，吴珍珍）

收稿日期:2022-05-15 出版日期:2023-04-15 发布日期:2023-04-24
通讯作者: 吴珍珍，E-mail：2396530559@qq.com
基金资助:
甘肃省卫生健康行业科研计划项目(GSWSKY2020-16);甘肃省科技计划项目(22JR5RA718)

Rhabdomyolysis after Laparoscopic Surgery for Cervical Cancer: A Case Report and Literature Review

LI Juan, XU Xiao-ying, SHENG Yan-nan, MA Fu-tang, ZHAO Ya-qin, WANG Fang, WU Zhen-zhen()

Gansu Provincial Maternity and Chid-Care Hospital, Lanzhou 730050, China (LI Juan, XU Xiao-ying, SHENG Yan-nan, MA Fu-tang, ZHAO Ya-qin, WANG Fang, WU Zhen-zhen); First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou 730000, China (XU Xiao-ying, WU Zhen-zhen)

Received:2022-05-15 Published:2023-04-15 Online:2023-04-24
Contact: WU Zhen-zhen, E-mail: 2396530559@qq.com

摘要/Abstract

摘要：

横纹肌溶解症（rhabdomyolysis）是各种因素导致的横纹肌破坏、崩解，引起机体内环境紊乱甚至急性肾衰竭的临床综合征。回顾性分析1例宫颈癌根治术后发生的横纹肌溶解症，其发生与全身麻醉状态、手术体位、长时间制动有关，临床表现为肌痛、乏力和深色尿，血清肌酸激酶、肌红蛋白升高，经扩容、利尿、连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）后痊愈。旨在引起医生重视因长时间手术、被动体位导致的横纹肌溶解症，强调在患者清醒状态下摆放手术体位的重要性。

关键词: 横纹肌溶解, 急性肾损伤, 宫颈肿瘤, 妇科外科手术, 肌红蛋白尿

Abstract:

Rhabdomyolysis (RM) is a well-known clinical syndrome caused by the breakdown and necrosis of muscle tissue. It can lead to electrolyte abnormalities and acute kidney injury. A case of RM is analyzed retrospectively during laparoscopic surgery for cervical cancer. It is related to the state of general anesthesia, surgical position and long time immobilization. It is characterized by muscle pain, weakness, and dark pigmentation of the urine. The diagnosis is confirmed by elevated creatine kinase and myoglobin levels. The management of RM is prompt intravenous volume expansion, maintainous urine output, and continuous renal replacement therapy (CRRT). Doctors need to pay attention to the intro-operative RM. Prolonged duration and passive position of surgery is a well-recognized risk factor in the development of RM. It emphasize the importance of placing the patient in the surgical position in the awake state.

Key words: Rhabdomyolysis, Acute kidney injury, Uterine cervical neoplasms, Gynecologic surgical procedures, Myoglobinuria

李娟, 许晓英, 盛燕楠, 马福堂, 赵雅琴, 王芳, 吴珍珍. 宫颈癌腹腔镜手术后横纹肌溶解症一例诊治体会[J]. 国际妇产科学杂志, 2023, 50(2): 234-236.

LI Juan, XU Xiao-ying, SHENG Yan-nan, MA Fu-tang, ZHAO Ya-qin, WANG Fang, WU Zhen-zhen. Rhabdomyolysis after Laparoscopic Surgery for Cervical Cancer: A Case Report and Literature Review[J]. Journal of International Obstetrics and Gynecology, 2023, 50(2): 234-236.

参考文献 22

[1]	Cabral BMI, Edding SN, Portocarrero JP, et al. Rhabdomyolysis[J]. Dis Mon, 2020, 66(8):101015. doi: 10.1016/j.disamonth.2020.101015. doi: 10.1016/j.disamonth.2020.101015
[2]	Bisaccia C, De Santo NG, De Santo LS. Antonino D′Antona (1842-1913) was the first in describing the crush syndrome with renal failure following the Messina earthquake of December 28, 1908[J]. G Ital Nefrol, 2016, 33(Suppl 66):33.S66.10.
[3]	Huerta-Alardín AL, Varon J, Marik PE. Bench-to-bedside review: Rhabdomyolysis -- an overview for clinicians[J]. Crit Care, 2005, 9(2):158-169. doi: 10.1186/cc2978. doi: 10.1186/cc2978
[4]	Gonzalez D. Crush syndrome[J]. Crit Care Med, 2005, 33(Suppl 1):S34-S41. doi: 10.1097/01.ccm.0000151065.13564.6f. doi: 10.1097/01.ccm.0000151065.13564.6f
[5]	Chakravartty S, Sarma DR, Patel AG. Rhabdomyolysis in bariatric surgery: a systematic review[J]. Obes Surg, 2013, 23(8):1333-1340. doi: 10.1007/s11695-013-0913-3. doi: 10.1007/s11695-013-0913-3 pmid: 23564464
[6]	Grammer R, Wang J, Lahey E. Rhabdomyolysis After Prolonged Surgery: Report of 2 Cases and Review of Literature[J]. J Oral Maxillofac Surg, 2018, 76(7):1424-1430. doi: 10.1016/j.joms.2018.01.016. doi: 10.1016/j.joms.2018.01.016
[7]	Omar AS, Ewila H, Aboulnaga S, et al. Rhabdomyolysis following Cardiac Surgery: A Prospective, Descriptive, Single-Center Study[J]. Biomed Res Int, 2016, 2016:7497936. doi: 10.1155/2016/7497936. doi: 10.1155/2016/7497936
[8]	Nakashima K, Matsunaga Y, Ohara K, et al. Rhabdomyolysis during Perioperative Period after Cardiac Surgery[J]. Kyobu Geka, 2020, 73(12):987-990.
[9]	Glassman DT, Merriam WG, Trabulsi EJ, et al. Rhabdomyolysis after laparoscopic nephrectomy[J]. JSLS, 2007, 11(4):432-437.
[10]	王冰, 黄慧选, 李进峰, 等. 维库溴铵致横纹肌溶解1例分析[J]. 药学研究, 2022, 41(3):209-210. doi: 10.13506/j.cnki.jpr.2022.03.016. doi: 10.13506/j.cnki.jpr.2022.03.016
[11]	张淼, 牛冬梅, 杨蓓蓓, 等. 超声诊断军事训练致横纹肌溶解症2例[J]. 人民军医, 2019, 62(6):569-571.
[12]	Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury[J]. N Engl J Med, 2009, 361(1):62-72. doi: 10.1056/NEJMra0801327. doi: 10.1056/NEJMra0801327
[13]	高楚淇, 强薇, 王金龙, 等. 144例横纹肌溶解综合征临床特征分析[J]. 遵义医科大学学报, 2020, 43(5):629-634. doi: 10.14169/j.cnki.zunyixuebao.2020.0112. doi: 10.14169/j.cnki.zunyixuebao.2020.0112
[14]	Chavez LO, Leon M, Einav S, et al. Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice[J]. Crit Care, 2016, 20(1):135. doi: 10.1186/s13054-016-1314-5. doi: 10.1186/s13054-016-1314-5
[15]	Huang SY, Lee IK, Liu JW, et al. Clinical features of and risk factors for rhabdomyolysis among adult patients with dengue virus infection[J]. Am J Trop Med Hyg, 2015, 92(1):75-81. doi: 10.4269/ajtmh.14-0343. doi: 10.4269/ajtmh.14-0343
[16]	Stahl K, Rastelli E, Schoser B. A systematic review on the definition of rhabdomyolysis[J]. J Neurol, 2020, 267(4):877-882. doi: 10.1007/s00415-019-09185-4. doi: 10.1007/s00415-019-09185-4 pmid: 30617905
[17]	Liu C, Wang H, Zhu C, et al. Diagnostic and Differential Diagnostic Significance of Laboratory Markers in Crayfish-Associated Rhabdomyolysis[J]. Ann Clin Lab Sci, 2018, 48(2):146-151. pmid: 29678839
[18]	Roxin LE, Venge P, Friman G, et al. Radioimmunoassays of human myoglobin in serum and urine[J]. Scand J Clin Lab Invest, 1979, 39(1):37-46. doi: 10.3109/00365517909104937. doi: 10.3109/00365517909104937
[19]	赵云艽, 赵娜, 彭荣. CRRT治疗横纹肌溶解症合并急性肾功能衰竭的疗效研究[J]. 基层医学论坛, 2021, 25(4):588-589. doi: 10.19435/j.1672-1721.2021.04.071. doi: 10.19435/j.1672-1721.2021.04.071
[20]	Maccario M, Fumagalli C, Dottori V, et al. The association between rhabdomyolysis and acute renal failure in patients undergoing cardiopulmonary bypass[J]. J Cardiovasc Surg(Torino), 1996, 37(2):153-159.
[21]	Goldberg M, Stecker JF Jr, Scarff JE Jr, et al. Rhabdomyolysis associated with urethral stricture repair: report of a case[J]. J Urol, 1980, 124(5):730-731. doi: 10.1016/s0022-5347(17)55631-1. doi: 10.1016/s0022-5347(17)55631-1 pmid: 7452806
[22]	Nimmo GR, Stewart SM, English PJ. Myoglobinuric acute renal failure associated with major urological surgery--an avoidable problem?[J]. Intensive Care Med, 1988, 14(3):244-245. doi: 10.1007/BF00718000. doi: 10.1007/BF00718000

宫颈癌腹腔镜手术后横纹肌溶解症一例诊治体会

Rhabdomyolysis after Laparoscopic Surgery for Cervical Cancer: A Case Report and Literature Review

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