车祸地震-挤压综合症（Car accident earthquake crush syndrome）.docVIP

车祸地震-挤压综合症（Car accident earthquake crush syndrome） Crush syndrome Crush syndrome English Name: crush syndrome Definition: compartment syndrome deterioration caused by acute renal failure with hyperkalemia, hyperphosphatemia, myoglobinaemia and myoglobinuria as the main manifestation. Crush syndrome (crush syndrome) crush syndrome refers to rock earth pressure buried, especially muscle plump body was pressed for more than an hour (such as thigh) and cause the pathological changes of the body, a series of major clinical manifestations of urinary oliguria even without, the renal failure characteristics. Renal failure is a serious condition, such as the delay in treatment, and the consequences are serious. After injury, toxic and intermediate metabolites of blood and tissue proteins are broken down and absorbed into the blood resulting from traumatic acute tubular necrosis and acute renal failure caused by it. This is a common cause of late death in patients with extensive soft tissue contusion. I. etiology Crush syndrome occurs mainly in housing collapse, engineering collapse, traffic accidents and other accidental injuries. In the war, a severe earthquake and other serious disasters may occur in batches. In addition, the patient is seen in coma and surgery, and the limb is immobilized by a fixed position for a long time. Two 、 pathophysiology The muscle suffered smashed wounds, bleeding and swelling, muscle tissue necrosis, and release a large number of metabolites, myoglobin, potassium, creatine, creatinine, muscle ischemia and hypoxia, acidosis can promote the potassium ions from the inside to the outside cell escape, so that blood potassium concentration increased rapidly. Limb crush injury after emergence of hypovolemic shock to peripheral vasoconstriction, kidney ischemia, renal blood flow and decreased glomerular filtration and renal tubular ball mainly depends on the glomerular artery, glomerular artery contraction, can aggravate the degree of renal tubular isc