延迟治疗的急性大腿骨筋膜室综合征保守治疗的评估
摘要
目的:评估汶川大地震中大腿骨筋膜室综合征(acute compartment syndrome of the thigh,ACST)患者在延迟治疗后的保守治疗效果。方法:收治6例遭受非接触性挤压伤的ACST合并急性肾功能衰竭患者,在平均延迟治疗35.4 h后接受了综合保守治疗。对出院前后的肢体损伤严重程度(mangled extremity severityscore,MESS)及肾功能相关数据进行相关性分析,并在伤后2.5年评估其临床结果。结果:6例患者均保存肢体,伤后2.5年患肢的功能恢复良好;MESS及初次治疗时间均与肾功能无相关关系(均P>0.05);二者各自均与感觉及运动开始恢复时间存在相关关系(均r>0.8,P<0.05)。结论:ACST只要遭受非接触挤压伤,如MESS<7,即使延迟的保守治疗也可获得较好的临床结果。
引文
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Matsen F AⅢ,Winquist R A,Krugmire R B Jr.Diagnosisand management of compartmental syndromes[J].J Bone JointSurg,1980,62(2):286-291.
Cascio B M,Buchowski J M,Frcsscia F J.Well-limbcompartment syndrome after prolonged lateral decubituspositioning:A report of two cases[J].J Bone Joint Surg,2004,86-A(9):2038-2040.
Mithfer K,Lhowe D W,Altman G T.Delayed presentation ofacute compartment syndrome after contusion of the thigh[J].JOrthop Trauma,2002,16(6):436-438.
Hope M J,McQueen M M.Acute compartment syndrome in theabsence of fracture[J].J Orthop Trauma,2004,18(4):220-224.
Burns B J,Sproule J,Smyth H.Acute compartment syndromeof the anterior thigh following quadriceps strain in a footballer[J].Br J Sports Med,2004,38(2):218-220.
Reis N D,Better O S.Mechanical muscle-crush injury and acutemuscle-crush compartment syndrome:with special reference toearthquake casualties[J].J Bone Joint Surg Br,2005,87-B(4):450-453.
MacKenzie E J,Bosse M J,Kollam J F,et al.Factorsinfluencing the decision to amputate or reconstruct after high-energy lower extremity traum[J].J Trauma,2002,52(4):641-649.
Robinson D,On E,Halperin N.Anterior compartmentsyndrome of the thigh in athletes:indications for conservativetreatment[J].J Trauma,1992,32(2):183-186.
Matsen F AⅢ,Winquist R A,Krugmire R B Jr.Diagnosisand management of compartmental syndromes[J].J Bone JointSurg,1980,62(2):286-291.
Cascio B M,Buchowski J M,Frcsscia F J.Well-limbcompartment syndrome after prolonged lateral decubituspositioning:A report of two cases[J].J Bone Joint Surg,2004,86-A(9):2038-2040.
Mithfer K,Lhowe D W,Altman G T.Delayed presentation ofacute compartment syndrome after contusion of the thigh[J].JOrthop Trauma,2002,16(6):436-438.
Hope M J,McQueen M M.Acute compartment syndrome in theabsence of fracture[J].J Orthop Trauma,2004,18(4):220-224.
Burns B J,Sproule J,Smyth H.Acute compartment syndromeof the anterior thigh following quadriceps strain in a footballer[J].Br J Sports Med,2004,38(2):218-220.
Reis N D,Better O S.Mechanical muscle-crush injury and acutemuscle-crush compartment syndrome:with special reference toearthquake casualties[J].J Bone Joint Surg Br,2005,87-B(4):450-453.
MacKenzie E J,Bosse M J,Kollam J F,et al.Factorsinfluencing the decision to amputate or reconstruct after high-energy lower extremity traum[J].J Trauma,2002,52(4):641-649.
Robinson D,On E,Halperin N.Anterior compartmentsyndrome of the thigh in athletes:indications for conservativetreatment[J].J Trauma,1992,32(2):183-186.
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