急诊患者遗传代谢病的快速识别与急救
Speedy identification of inherited metabolic diseases in emergency and critical care center
摘要遗传代谢病患者一旦急性发病,多陷于严重中毒、能量代偿不足、神经意识昏睡状态,诊断治疗不及时会导致严重的脑损伤或发育障碍,因此就诊时需要快速有效的代谢检测来明确诊断、决定治疗方案.急诊就诊30 min之内的紧急实验室一线检查结果是鉴别诊断和制定抢救治疗方案的重要参考依据,相继24 h内根据一线检查结果完善相应的遗传代谢病的二线实验室检查是明确诊断遗传代谢病和采取有效治疗方案的关键.
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abstractsAcute severe manifestations of inherited metabolic diseases include disorders of the intoxication,disorders with disturbed energy metabolism and disorders of neurotransmission.Therefore,early diagnosis and treatment must be initiated in order to decrease risk of mental injury and damages or acute death.Emergency treatment need speedy diagnosis of inherited metabolic diseases and diagnostic emergency first line laboratory evaluation should cover all differential diagnosies.All of the first line laboratory results are indispensable for planning and conducting the first steps of metabolic emergency treatment and should be available within 30 min.According to the clinical situation and biochemical derangement,secondary special metabolic investigations must be initiated in parallel.The results of all laboratory investigations relevant to the diagnosis of metabolic disorders for which specific emergency therapy exists should be available within 24 h.
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