Crush syndrome of multiple organ failure caused two cases of treatment experience.docVIP

 PAGE \* MERGEFORMAT 8 Crush syndrome of multiple organ failure caused two cases of treatment experience [Keywords:] crush syndrome of multiple organ failure Crush syndrome and more because of the earthquake, mine collapse, car accidents, war and other reasons, physical oppression of external objects, caused by the trunk, the clinical course dangerous, if not rescue, the prognosis is poor, according to foreign literature, the mortality rate of up to 65 %, often associated with multiple organ failure, renal failure which the highest incidence. for 5.12 Wenchuan earthquake, our department recently treated 2 patients with crush syndrome in patients with multiple organ failure caused by an active rescue, 1 cases improved, 1 patient died, described below. Case Introduction Example 1: The patient, female, 10 years old. By 5.12 earthquake collapsed houses were rescued after 12 hours buried, the body after crush injury 3 d, vomiting, stomach contents of brown with oliguria 1d on May 15, 2008 by primary Hospital transferred to our hospital ICU. admission, urine output 200 ~ 300 ml / d. examination: T36.2 , P110 beats / min, BP131/75 mmHg. Shen Qing, passive posture, body mucosa yellow dye, body skin multiple bruises, skin bruises, ecchymosis, middle trachea, thorax symmetrical, lungs coarse breath sounds, no smell, and wet and dry rales, heart rate 110 beats / min, the law together, did not hear and pathological murmurs, abdomen soft, whole abdomen without tenderness, rebound tenderness, moderate swelling of the left upper limb, both lower extremities with mild swelling of the left radial artery and the dorsalis pedis artery pulse palpable. X-ray films do not contain any fractures. check routine blood test showed: WBC 18.21 109 / L, N 85.0%, HGB 120 g / L, PLT 176 109 / L. liver function, renal function, electrolyte showed: AST 1700 U / L, ALT 622 U / L, ALB 21.7 g / L, LDH 13715U / L, BUN 21.29 mmol / L, Cr 220.4 mol / L, K +5.54 mmol / L, Na +126.2 mmol