负压封闭引流技治疗骨筋膜室综合征18例临床分析.docVIP

负压封闭引流技术治疗骨筋膜室综合征18例临床分析 　　[摘要] 目的 为探讨负压封闭引流技术（VSD）在治疗骨筋膜室综合征的临床效果。方法 方便选取该院自2014年3月―2016年3月收治的18例骨筋膜室综合征的患者临床资料，所有患者均在确诊骨筋膜室综合征后行筋膜切开减压术联合VSD技术治疗，记录患者术后感染和创面愈合情况。结果 13例创面肉芽生长新鲜，呈颗粒状，予以直接缝合处理，3例创面出现部分肌肉疑似缺血坏死，行清创植皮术，2例创面出现感染征象，行清创及VSD敷料替换治疗后治愈，所有患者经治疗后伤口愈合良好，所有患者均无严重并发症出现，无下肢肌力减退、感觉障碍、关节僵硬等症状。结论 切开减压术联合负压封闭引流技术治疗骨筋膜室综合征能迅速降低筋膜间室内压力，同时避免不能Ⅰ期闭合的创面发生感染的风险，为残留创面的愈合创造良好的基础条件。 中国论文网 /6/viewhtm 　　[关键词] 负压封闭引流；切开减压；骨筋膜室综合征 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）09（b）-0041-03 　　[Abstract] Objective This paper tries to investigate the clinical effect of vacuum sealing drainage （VSD） in the treatment of compartment syndrome. Methods Convenient selection the clinical data of 18 cases of osteofascial compartment syndrome in this hospital from March 2014 to March 2016 were collected. After all patients being diagnosed with osteofascial compartment syndrome， the fasciotomy decompression combined with VSD treatment were carried out， and the postoperative infection and wound healing of patients were recorded. Results 13 cases of fresh granulation growth， liked granular and received direct suture treatment； 3 cases of wound partial muscle suspected ischemic necrosis， debridement and skin grafting were implemented； 2 cases of wound infection， debridement and dressing VSD for replacement and were cured after treatment； the wound of all patients after treatment healed well， with no serious complications or lower extremity sensory dysfunction， decreased muscle strength， joint stiffness or other symptoms. Conclusion Incision decompression combined with vacuum sealing technique for the treatment of osteofascial compartment syndrome can rapidly reduce the indoor drainage pressure compartment， while avoiding the risk of incision infection of Ⅰstage without closure， and create good conditions for the healing of residual wound. 　　[Key words] Vacuum sealing drainage； Incision and decompression； Compartment syndrome 　　骨筋膜室?C合征是骨折后常见的并发症，其发生机制是筋膜室内压力增高，导致肌肉及神经缺血、缺氧而致局部水肿，进而