病毒性脑炎合并横纹肌溶解症的总结分析

Analysis of viral encephalitis complicated with rhabdomyolysis.

目的探讨病毒性脑炎患儿在疾病急性期合并横纹肌溶解症（rhabdomyolysis,RM）的发病情况、治疗效果及预后,以提高其诊治水平。方法总结分析我院2009年1月~2011年12月期间诊治的病毒性脑炎患儿,合并横纹肌溶解症的发病率、临床治疗及预后。结果 120例病毒性脑炎患儿有9例合并横纹肌溶解症,主要表现为急性尿色改变,典型者呈红褐色,实验室检查提示血清肌酸激酶显著升高,血清肌红蛋白升高,尿肌红蛋白阳性。经过水化、碱化、利尿等对症、支持治疗,所有患儿临床症状均好转,复查血清肌红蛋白下降,尿肌红蛋白阴性。结论病毒性脑炎患儿病程中可以合并横纹肌溶解症且并不罕见,在临床上应引起高度重视。

Objective To explore and analyze the clinical manifestations and treatment effectiveness of viral encephalitis complicating rhabdomyolysis,in order to improve its diagnosis and management.Methods Summarized the incidence,clinical course and prognosis of viral encephalitis complicating rhabdomyolysis by retrospective analysis in our hospital from January,2009 to December,2012.Results Among the 120 viral encephalitis cases,9 cases complicated with rhabdomyolysis,presented with acute red discoloration of the urine while erythrocytes cannot be detected by microscopy.Urinary myoglobin provokes a typical reddish-brown color.The concentration of creatine kinase remains elevated and blood and urine myoglobin were positive.Via fluid administration,alkalinization,diuresisand other supportive treatment,all of the patients recovered well.Conclusion During the acute period of viral encephalitis,it is not rare that rhabdomyolysis can be occurred and it should be paid highly attention to.