维库溴铵致横纹肌溶解1例分析

A case of rhabdomyolysis caused by Vecuronium Bromide

1例61岁男性因手术给予“维库溴铵、舒芬太尼、依托咪酯、右美托咪定、七氟烷、丙泊酚”后第2天出现肌酸激酶升高。后因病情加重转入ICU,给予“维库溴铵20 mg+0.9%氯化钠注射液50 mL微量泵泵入”7 d后,患者尿量减少、呈棕色,实验室检查肌酸激酶最高可至18358 U·L^(-1),肌红蛋白>3000 ng·L^(-1),诊断为横纹肌溶解症。停用维库溴铵,给予补液、碱化尿液、利尿等治疗后7 d,实验室检查示肌酸激酶7212.4 U·L^(-1)、肌红蛋白>3000 ng·L^(-1)。15 d后患者尿量增多、尿色正常,实验室检查示肌酸激酶95 U·L^(-1)、肌红蛋白506 ng·L^(-1)。至出院患者未再出现尿量减少、颜色改变情况,肌酸激酶等实验室检查未再发生异常。

Elevated creatine kinase was observed in a 61-years-old male 2 days after surgical administration of"vecuronium,sufentanil,etomidate,dexmedetomidine,sevoflurane,and propofol".After 7 days,the patient was transferred to ICU and given"vecuronium bromide 20 mg+0.9%Sodium Chloride Injection 50 mL micropump".The patient′s urine volume was reduced and turned brown,and the maximum creatine kinase by laboratory examination was 18358 ng·L^(-1),myoglobin>3000 ng·L^(-1),which was diagnosed as rhabdomyolysis.Seven days after the withdrawal of vecuronium bromide and the administration of fluid rehydration,alkalized urine and diuretic treatment,laboratory tests showed creatine kinase 7212.4 U·L^(-1) and myoglobin>3000 ng·L^(-1).After 15 days,the patient had increased urine volume and normal urine color.Laboratory tests showed creatine kinase 95 U·L^(-1) and myoglobin 506 ng·L^(-1).No decrease in urine volume or color change was observed until the patient was discharged from hospital,and no abnormalities were observed in laboratory tests such as creatine kinase.