地震所致骨筋膜室综合征29例诊治分析潘勇郝勇阴金波姚家文杨辉.DOCVIP

地震所致骨筋膜室综合征29例诊治分析 潘勇 郝勇 阴金波 姚家文 杨辉 丁生才 周人杰 第三军医大学新桥医院驻德阳医疗队 ［摘要］ 目的：总结29例地震所致骨筋膜室综合征早期诊断和治疗的方法，以提高大规模灾难救治中骨筋膜室综合征的诊治水平。方法：对第三军医大学新桥医院驻德阳医疗队接诊的地震伤员中诊治的29例骨筋膜室综合征的临床资料进行回顾性分析。结果：手术切开减压29例，其中治愈24例，占82.8％；基本治愈3例，占 10.3％；截肢2例，占6.9％。结论：骨筋膜室综合征的早期发现不能简单地以足背动脉搏动减弱或消失为依据；一旦发现骨筋膜室综合征，应尽早切开减压。 ［关键词］ 地震；骨筋膜室综合征；切开减压。 Diagnosis and Treatment of Osteofascial Compartment Syndrom in Earthquakes: 29 Cases Report Pan Yong, Hao Yong, Yin Jinbo, Yao Jiawen,Yang Hui, Ding Shengcai, Zhou Renjie (De Yang Medical Team ,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China) Abstract: Object:To summarize earlier diagnosis and treatment of Osteofascial Compartment Syndrom in 29 cases injured in Earthquakes and to elevate the level of diagnosis and treatment of Osteofascial Compartment Syndrom in disaster remedy. Method: To analyze retrospectively the clinical data of Osteofascial Compartment Syndrom in 29 cases injured in Earthquakes treated by De Yang Medical Team sent by Xinqiao Hospital Third Military Medical University.Result:All the 29 cases were treated with open decompression.24 cases were cured with cure rate 82.8%.3 cases were basic cure with basic cure rate 10.3%.2 cases were amputated with amputation rate 6.9%.Conclusion:The earlier diagnosis of Osteofascial Compartment Syndrom should not primitively based on weakened or disappeared pulsation of arteriae dorsalis pedis. As soon as Osteofascial Compartment Syndrom were found, open decompression should be taken immediately. Key words: Earthquake, Osteofascial Compartment Syndrome, Open Decompression 骨筋膜室综合征是指骨筋膜室内组织体积增大或空间变小使间隙内压力增高，达到一定程度后出现间隙内肌肉、神经的血液循环障碍，造成肌肉坏死、神经麻痹。地震伤员中挤压伤和严重四肢骨折是骨筋膜室综合征的常见原因。为了提高大规模灾难救治中骨筋膜室综合征的诊治水平，现将本医疗队诊治的骨筋膜室综合征伤员的诊治情况进行总结。 1对象与方法 1.1一般资料 本组29例骨筋膜室综合征中，男18例，女11例，最大年龄72岁，最小年龄11岁。受伤原因：地震房屋倒塌所致挤压伤27例，地震时高处坠落2例。受伤部位：前臂7例，小腿22例。伤后接诊时间：伤后12小时内24例，伤后24小时内3例，伤后24小时以后2例。患肢单纯软组织损伤者8例，合并患肢骨折者21例。 1.2临床表现 29例患者患肢均表现为超出原发损伤的逐渐加重的剧烈自发痛，高张力性肢体肿胀，深压痛及被动牵拉痛阳性，患肢远端套式麻木，痛觉减退或消失，远端血管搏动正常、减弱或消失。7例有