特大地震中儿童骨筋膜室综合征的护理
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摘要
通过对27例地震伤儿童肢体骨筋膜室综合征的诊治和护理,探讨其合理的判断指标及治疗护理措施。早期密切观察患肢肿胀情况、采取积极有效的护理措施,包括四肢末梢血氧饱和度检测,对血氧饱和度低于90%的2例行骨筋膜室切开减压术;予抗炎、半量甘露醇加β-七叶皂甙钠脱水消肿治疗;16例肢体骨折患者及时予石膏托或支具外固定。结果22例治疗成功保住了患肢;4例截肢(1例膝下、3例膝上);1例死亡。认为对儿童肢体骨筋膜室综合征进行早期密切观察并采取及时有效的护理措施是保证治疗成功和预防并发症的关键;患肢末梢血氧饱和度检测是一个可靠、直观、可行的判断指标;早期半量甘露醇加β-七叶皂甙钠脱水消肿、积极抗炎、配合支架外固定等综合治疗效果良好。
By means of diagnose and nursing for a group of 27 children with osteofascial compartment syndrome caused by earthquake, to explore the reasonable judgment indicators and treatment and nursing measures of this kind of disease. Admitted to hospital,closely observe the situation of the swollen limb,and take positive and effective care measures,testing the oxygen saturation of the ending limb,the 2 cases whose blood oxygen saturation was less than 90% were adopted Osteofascial compartment decompression incision; anti-inflammatory,infused of Mannitol and β-aescun sidium to dehydration;16cases with limbs fractures were fixed by cast or brace in time. At the result,22cases were recovery and kept the limbs,four cases of amputations(one case of below-knee,3 cases of knee),one case of death. Considering that Early close observation and taking timely and effective care measures is the key to ensure the success of the treatment and prevention of complications ;the monitoring of ill limb end blood oxygen saturation is a reliable,intuitive,feasibly judgment indicator;early to infuse the half dose Mannitol and β-aescun sidium to dehydration ,the effect of this comprehensive treatment is effective.
By means of diagnose and nursing for a group of 27 children with osteofascial compartment syndrome caused by earthquake, to explore the reasonable judgment indicators and treatment and nursing measures of this kind of disease. Admitted to hospital,closely observe the situation of the swollen limb,and take positive and effective care measures,testing the oxygen saturation of the ending limb,the 2 cases whose blood oxygen saturation was less than 90% were adopted Osteofascial compartment decompression incision; anti-inflammatory,infused of Mannitol and β-aescun sidium to dehydration;16cases with limbs fractures were fixed by cast or brace in time. At the result,22cases were recovery and kept the limbs,four cases of amputations(one case of below-knee,3 cases of knee),one case of death. Considering that Early close observation and taking timely and effective care measures is the key to ensure the success of the treatment and prevention of complications ;the monitoring of ill limb end blood oxygen saturation is a reliable,intuitive,feasibly judgment indicator;early to infuse the half dose Mannitol and β-aescun sidium to dehydration ,the effect of this comprehensive treatment is effective.
引文
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2卫小春,张志强,韩来春,等.甘露醇对肢体缺血再灌注损伤的保护作用[J].中华骨科杂志,1995,15(6):370～372.
3Dorman HR,Sondheimer JH,Cadnapaphornchai P.Mannotol in-duced acute renal failure[J].Medicine,1990,69(7):153～159.
4赵英军,闫晓娟.儿童前臂筋膜室综合征延误诊疗分析[J].河北医药,2000,6(22):465.
5工亦聪,孟继懋,郭白恒.骨与关节损伤[J].第2版.北京:人民卫生出版社,1991:152.
6季滢瑶,黄忠胜,胡广,等.骨折合并骨筋膜间室综合征的早期诊断和治疗[J].实用骨科杂志,2003,9(1):64.
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