Rhabdomyolysis

Rhabdomyolysis ʻo ia ka haki o nāʻiʻo i kū i ka hoʻokuʻu ʻia ʻana o nā ʻikepili pulupulu i loko o ke koko. Hoʻopilikia kēia mau mea i ka puʻupaʻa a hoʻopōʻino pinepine i nā puʻupaʻa.

Ke hōʻino ʻia ka mākala, hoʻokuʻu ʻia kahi protein i kapa ʻia ʻo myoglobin i ke kahe o ke koko. Hoʻopili ʻia ia i waho o ke kino e nā puʻupaʻa. Wāwahi ʻo Myoglobin i nā mea i hiki ke hōʻino i nā hunaola hakuʻala.

Hoʻokumu ʻia ʻo Rhabdomyolysis e ka ʻeha a i ʻole nā ​​ʻano ʻē aʻe e hōʻino ai i nā mākala iwi.

ʻO nā pilikia i hiki ke alakaʻi i kēia maʻi me:

• Ka hōʻeha a i ʻole nā ​​ʻeha ʻeha
• Hoʻohana i nā lāʻau e like me cocaine, amphetamines, statins, heroin, a PCP paha
• Nā maʻi mākala genetic
• ʻOi aku ka wela o ke kino
• Ischemia a i ʻole ka make ʻana o nāʻiʻo puʻupuʻu
• Nā pae phosphate haʻahaʻa
• ʻO ka hopu ʻana a i ʻole nā ​​haʻalulu o nā mākala
• ʻO ka hoʻoikaika nui, e like me ka holo ʻana i ka marathon a i ʻole nā ​​calisthenics
• Nā kaʻina hana lōʻihi lōʻihi
• Ka make nui loa ʻana

Pākuʻi ʻia paha nā ʻōuli:

• Mimi ʻeleʻele, ʻulaʻula, a cola paha
• Hoʻoemi i ka puka mimi
• Nāwaliwali laulā
• ʻOʻoleʻa ka ʻili a ʻeha paha (myalgia)
• Palupalu mākala
• Nāwaliwali o nā mākala i hoʻopili ʻia

Nā ʻōuli ʻē aʻe i hiki ke loaʻa me kēia maʻi.

• Ka luhi
• ʻEha hui
• Ka hopu ʻana i nā maʻi
• Ka waiwai kaupaona (noʻonoʻo ʻole)

E hōʻike kahi hōʻike kino i nā mākala iwi a palupalu paha.

E hana ʻia paha kēia mau hoʻāʻo:

• Creatine kinase (CK) pae
• Kalipuna serum
• Myoglobin kolo
• Pāhare potassium
• Urinalysis
• Hōʻike myoglobin mimi

Hiki paha i kēia maʻi ke hoʻopili i nā hopena o nā hōʻike aʻe:

• CK isoenzymes
• Serum creatinine
• Mīkini hakuʻine

Pono ʻoe e kiʻi i nā wai i loko o ka bicarbonate e kōkua ai i ka pale ʻana i ka hōʻino ʻana o ka hakuʻala. Pono ʻoe e kiʻi i nā wai ma o kahi aa koko (IV). Pono paha kekahi poʻe i ka dialysis kidney.

Hiki i kāu kauka olakino ke kuhikuhi i nā lāʻau e like me diuretics a me bicarbonate (inā lawa ka hana mimi).

Pono e mālama koke ʻia ʻo Hyperkalemia a me nā pae calcium o ke koko haʻahaʻa (hypocalcemia). Pono e mālama ʻia ka hakuʻala maikaʻi ʻole.

Pili ka hopena i ka nui o ka hōʻino ʻana o ka hakuʻala. Kūpono ʻole ka hakuʻala ʻole i nā poʻe he nui. ʻO ka mālama ʻana ma hope koke iho o ka rhabdomyolysis e hoʻēmi ai i ka makaʻu o ka hōʻino mau o ke kīhāpai.

Hiki i ka poʻe me nā hihia momona ke hoʻi i kā lākou hana maʻamau i loko o kekahi mau pule a hoʻokahi mahina. Eia nō naʻe, hoʻomau kekahi i kekahi mau pilikia me ka luhi a me nā ʻehaʻeha o nā mākala.

Komo pū nā pilikia:

• Nekrosis tubular koʻikoʻi
• Hoka kōpaʻa koʻikoʻi
• ʻO ke kaulike ʻole ʻino i loko o ke koko
• Pākuʻi (hoʻohaʻahaʻa koko)

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o ka rhabdomyolysis.

Hiki ke hōʻalo ʻia ʻo Rhabdomyolysis e:

• Ke inu nei i nā wai he nui ma hope o ka hoʻoikaika ikaika.
• Ke hemo nei i nā lole keu a me ka hoʻohuʻu ʻana i ke kino i ka wai anuanu i ka wela wela.

• Anatomia hakuʻala

Haseley L, Jefferson JA. Pathophysiology a me etiology o hōʻeha hakuʻala ʻeha. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 66.

O'Connor FG, Deuster PA. Rhabdomyolysis. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier; 2020: chap 105.

Parekh R. Rhabdomyolysis. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 119.