如果危机没有得到适当的治疗,恶性高热(MH)可能是致命的。它是一种遗传性疾病,通常由挥发性吸入麻醉药和/或琥珀酰胆碱的给药引发,肌肉松弛剂.一名疑似MH的患者,钙在骨骼肌肌浆网中的储存释放机制异常加速。无法解释的高碳酸血症代表潮气末二氧化碳>55mmHg,心动过速,肌肉僵硬(包括咬肌僵硬)是MH开始的早期迹象,因为新陈代谢加速。体温可以升高>0.5°C/15分钟,并可能达到≥40°C。呼吸和代谢性酸中毒,心律失常,可乐色的尿液,血清钾水平升高,心电图上的T波是常见的,可导致心脏骤停。MH应通过停用触发剂进行治疗,静脉注射丹曲林(最初为1mg/kg),和降低体温。早期诊断和充分降低体温的丹曲林对于缓解患者的MH危象至关重要。本指南日语翻译已在网站上发布:http://www。Anesth.或者。jp/guide/pdf/guideline_akuseikounetsu.PDF。
Malignant hyperthermia (MH) can be fatal if the crisis is not appropriately treated. It is an inherited disease usually triggered by the administration of volatile inhalational anesthetics and/or succinylcholine, a muscle relaxant. In a patient with suspected MH, the mechanism of calcium release from storage in the sarcoplasmic reticulum in the skeletal muscle is abnormally accelerated. Unexplained hypercarbia representing >55 mmHg of end-tidal carbon dioxide, tachycardia, and muscle rigidity (including masseter muscle rigidity) are early signs of the initiation of MH, because the metabolism is accelerated. The body temperature can rise by >0.5 °C/15 min and may reach ≥40 °C. Respiratory and metabolic acidosis, arrhythmia, cola-colored urine, increased levels of serum potassium, and tented T-waves on electrocardiogram are common and can lead to cardiac arrest. MH should be treated by discontinuation of the triggering agents, administration of intravenous dantrolene (initially 1 mg/kg), and reduction of the body temperature. Early diagnosis and sufficient dantrolene with body temperature reduction are essential to relieve the patient\'s MH crisis. This guideline in Japanese translation has been posted on the website: http://www.anesth.or.jp/guide/pdf/guideline_akuseikounetsu.pdf .