横紋筋融解症の臨床所見と治療

Clinical findings and therapy in cases of severe rhabdomyolysis

　血清CK値10,000I∪／l以上を示した重症横紋筋融解症22例の臨床所見，治療，予後につき検討した．横紋筋融解症の原因は外傷，糖尿病，アルコール，敗血症，悪性症候群など様々であった．その臨床所見は，筋肉痛，筋力低下，尿潜血と尿中赤血球の解離，代謝性アシドーシス，白血球増多，血小板数減少，血清リン値低下等多彩であった．早期に尿量を十分に得る治療をすれば腎不全は防がれ，予後は良好であった．

We reviewed clinical findings and therapies in 22 cases of rhabdomyolysis. Serum creatnine kinase values in these patients ranged from 10190~287600IU/l with an average of 55000IU/l.

Causes of rhabdomyolysis included trauma, diabetus mellitus, malignant syndrome, alcohol, hypothermia, sepsis, and so on. There were various clinical findings as follows ; leukocytosis thrombocytopenia, metabolic acidosis, positive urine myoglobin, and renal insufficiency.

Therapies conducted included hydration, dopamine, furosemide and hemodialysis ; Prognosis was excellent exept for one case who came to the hospital with anuria and developed renal failure requiring hernodialysis.

We concluded that rhabdomyolysis has various clinical features and that the prognosis in exellent with adequate therapies leading to early diuresis.