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症例は28歳.妊娠32週の女性。鈍的外力により受傷し,子宮内胎児死亡とクラッシュ症候群による急性腎不全を併発したため当科を紹介された。分娩に関しては経腟分娩を選択し,死産に至った。急性腎不全に関しては,血液濾過透析(hemo-diafiltration:HDF)を施行し,受傷後約30日で利尿期となった。血中ミオグロビン濃度が正常化した時点で腎機能は改善しており,血中ミオグロビン濃度は腎機能回復の良い指標と考えられた。
The patient was a 28-year-old female in the 32nd week of pregnancy. She suffered intrauterine fetal death and acute renal insufficiency due to crush syndrome because of blunt external force. She decided to choose the vaginal delivery, but her baby was born dead. For acute renal insufficiency, HDF using Eval membrane was per-formed for 18 times, and diuresis took place about 30 days after injury. The renal dysfunction recovered with normalization of serum myoglobin concentration. We propose HDF using Eval membrane for high removal rate of serum myoglobin for crush syndrome associated with acute renal failure.
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