Ultrasonic appearance of rhabdomyolysis in patients with crush injury in the Wenchuan earthquake.
Ultrasonic appearance of rhabdomyolysis in patients with crush injury in the Wenchuan earthquake.
复制标题
汶川地震挤压伤患者横纹肌溶解症的超声表现
DOI：
--
复制
发表时间：
2009-08
期刊：
影响因子：
--
通讯作者：
Peng YL
中科院分区：
文献类型：
--
作者：
QIU L;Luo Y;Fu P;Tao Y;Su BH;Peng YL
背景
2008年5月12日，中国四川省汶川县发生大地震。该事件后发生挤压伤的病例数很高。观察汶川地震挤压伤所致横纹肌溶解症（RM）的超声表现，探讨超声对横纹肌溶解症的诊断价值。
方法
本文分析了50例RM和18例RM合并骨筋膜室综合征（OCS）的临床和超声表现。所有病例均为汶川地震中挤压伤所致。对于这些RM患者，我们还评估了肌酸激酶（CK）与超声观察到的肌肉病变范围之间的相关性。
结果
两组患者在临床症状、体征及超声表现上存在差异。RM的超声特征为：病灶内横纹肌增厚，整体连续性好，肌肉纹理模糊;回声强弱不均，回声呈浑浊或磨玻璃样。肌肉间可见梭形或不规则的液性暗带。液性暗区无血流信号。OCS患者横纹肌体积增大，包裹横纹肌的筋膜呈拱形突起，移位明显。远端动脉血流速度减慢，频谱异常。RM组和RM + OCS组的肌肉病变范围分别为（7.8 ± 2.0）cm和（13.6 ± 3.1）cm。RM组肌肉病变范围与CK的相关系数r为0.681（P < 0.05），RM和OCS组的相关系数r为0.516（P < 0.05）。
结论
横纹肌溶解症的声像图具有特征性表现，可为临床诊断和治疗提供重要信息。
BACKGROUND
On May 12, 2008, a major earthquake hit Wenchuan County in Sichuan Province of China. The number of cases of crush injury following this event was high. Ultrasonic appearance of rhabdomyolysis (RM) caused by crush injury in the Wenchuan earthquake was observed to evaluate the diagnostic value of ultrasound for detection of rhabdomyolysis.
METHODS
We analyzed clinical and ultrasonic manifestations of 50 cases of RM and 18 cases of RM with osteofascial compartment syndrome (OCS). All cases were caused by crush injury in the Wenchuan earthquake. For these RM patients, we also evaluated the correlations between creatine kinase (CK) and the scope of the muscle lesions as observed by ultrasound.
RESULTS
There were differences in clinical symptoms, physical signs and ultrasonic appearance between the two groups of patients. The ultrasonic characteristics of the RM were as follows: the striated muscle in the lesions thickened with good overall continuity, and the muscle texture was vague; the strength of the echo was uneven and the echo was cloudy or ground glass-like. Liquid dark zones appeared between muscles and were spindle-like or irregular in shape. There were no blood flow signals in the liquid dark areas. The volume of the striated muscle increased in patients with OCS; the fascia wrapping the muscle showed arched protrusions and significant displacement. The flow velocity of the distal arteries decreased and the spectrum was abnormal. The muscle lesion scope of RM group and RM and OCS group was (7.8 +/- 2.0) cm and (13.6 +/- 3.1) cm, respectively. The correlation coefficient (r) between the muscle lesion scope and the CK was 0.681 for the RM group (P < 0.05) and 0.516 for the RM and OCS group (P < 0.05).
CONCLUSIONS
The ultrasonogram of RM has characteristic manifestations and can provide important information for clinical diagnosis and treatment of rhabdomyolysis.