多学科医院急性外源性中毒横纹肌溶解的患病率、结构、并发症发生率及治疗结果

S. V. Masolitin, D. Protsenko, I. N. Tyurin, O. Mamontova, M. Magomedov, T. Kim, A. V. Marukhov, N. V. Chubchenko
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摘要

介绍。根据各种国外消息来源,在因急性中毒而入院的人中,横纹肌溶解的患病率达到30%至40%。在60%的病例中,成年患者横纹肌溶解的发展与急性外源性中毒有关。目前,关于毒理学患者横纹肌溶解的患病率、结构和治疗结果的数据主要来自国外的临床和流行病学研究结果。目的是研究在多学科医院急性外源性中毒横纹肌溶解的患病率,结构,并发症的频率和治疗的结果。材料和方法。该研究包括2017年至2020年期间接受急性外源性中毒治疗的1363名患者。在研究中,从普通组中选取98例横纹肌溶解患者。分析了急性外源性中毒中各种毒物对横纹肌溶解的影响。检测急性肾损伤(AKI)发生率,测定急性中毒治疗结局及住院时间,并对急性外源性中毒横纹肌溶解患者组(n=98)和非横纹肌溶解患者组(n=1265)进行对比分析。结果。急性中毒住院患者横纹肌溶解患病率为7%。发生横纹肌溶解的主要原因是麻醉药物的使用(87%)。59.2%的急性外源性中毒患者发生横纹肌溶解时伴有AKI的发生,明显高于无横纹肌溶解的患者(11.6%)。毒理学患者横纹肌溶解的发生使住院死亡率从6.1%增加到10.2%,住院治疗和重症监护时间分别增加5.2天和3.3天。的局限性。该研究是在2017年至2020年期间仅在莫斯科一家多学科医院进行的。结论。横纹肌溶解是急性中毒的一种严重并发症,其发展会显著恶化有毒理学特征的患者的治疗结果,这就需要开发有效的方法来预防、诊断和治疗急性外源性中毒的横纹肌溶解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence, structure, frequency of complications and outcomes of treatment of rhabdomyolysis in acute exogenous intoxication in a multidisciplinary hospital
Introduction. The prevalence of rhabdomyolysis among people admitted to the hospital due to acute poisoning reaches, according to various foreign sources, from 30 to 40%. In 60% of cases, the development of rhabdomyolysis in adult patients is associated with acute exogenous intoxication. Currently, data on the prevalence, structure and outcomes of treatment of rhabdomyolysis in toxicological patients are mainly presented by the results of foreign clinical and epidemiological studies. The aim is to study the prevalence, structure, frequency of complications and outcomes of treatment of rhabdomyolysis in acute exogenous intoxication in a multidisciplinary hospital. Material and methods. The study included 1,363 patients who were treated from 2017 to 2020 with acute exogenous intoxication. During the study, 98 patients with rhabdomyolysis were selected from the general group. The frequency of poisoning with various toxicants was analyzed, the effects of which led to the development of rhabdomyolysis in acute exogenous intoxication. The incidence of acute kidney injury (AKI) was detected, the outcomes of acute poisoning treatment, the duration of inpatient treatment were determined, and a comparative analysis was carried out between groups of patients with rhabdomyolysis in acute exogenous intoxication (n=98) and without it (n=1265). Results. The prevalence of rhabdomyolysis among patients hospitalized for acute poisoning was 7%. The main reason for the development of rhabdomyolysis was the use of narcotic drugs - 87% of cases. The development of rhabdomyolysis in acute exogenous intoxication in 59.2% of cases is accompanied by the occurrence of AKI, which is significantly higher than among patients without rhabdomyolysis (11.6%). The occurrence of rhabdomyolysis in toxicological patients increases hospital mortality from 6.1 to 10.2%, as well as the duration of inpatient treatment and intensive care by 5.2 and 3.3 days, respectively. Limitations. The study was conducted based on only one multidisciplinary hospital in Moscow in the period from 2017 to 2020. Conclusion. Rhabdomyolysis is a serious complication of acute poisoning, the development of which significantly worsens the outcomes of treatment of patients with a toxicological profile, which requires the development of effective methods for the prevention, diagnosis and treatment of rhabdomyolysis in acute exogenous intoxication.
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