骨筋膜室综合征诊断与治疗的研究进展

doi:j.issn.1009-976X.2015.01.030

摘要/Abstract

摘要： 【摘要】〓骨筋膜室综合征(OCS)是指由各种原因造成的肢体创伤导致筋膜室内压力(ICP)升高,阻断筋膜室内组织微循环而引发的一系列症状和体征。目前其病理、病因已有明确的认识,即缺血4小时以上就可造成不可逆的损伤,早期准确诊断及选择适当的治疗方案就尤为重要。但目前临床上对该病诊断的准确性尚有所不足,治疗方案的选择仍有不同的见解。本文对OCS的早期诊断和动态监测以及治疗方法进行了回顾分析,旨在提高该病诊断的准确性,以及为该病的最佳处理方式提供指导。

关键词: 骨筋膜室综合征, 筋膜室内压, 诊断, 治疗

Abstract: 【Abstract】 Osteofascial compartment syndrome (OCS) occurs after tissue injury caused by several reasons such as fracture and casts. Because of tissue injury, compartment pressure rises to a high level resulting in microvascular perfusion interrupt and this induce some signs and symptoms. The pathologys and causes of the syndrome have already been recognized. It is important to make the early accurate diagnosis and select the appropriate treatment, because the ischaemic damage may be irreversible over six hours. However, the understanding of the clinic diagnosis is less and the clinic diagnosis accuracy is not high. There are many disagreements about the treatment of OCS because of its variety and lack of guideline. This review addresses early diagnosis, auxiliary examinations and treatments of OCS to promote diagnostic accuracy and provide guideline for the treatment.

Key words: Osteofascial compartment syndrome, Intracompartmental pressure, Diagnosis, Treatment

中图分类号:

R686.3

谢俊峰刘俊. 骨筋膜室综合征诊断与治疗的研究进展[J]. 岭南现代临床外科, 2015, 15(01): 111-114.

Xie Junfeng, Liu Jun. Research advances in diagnosis and treatment of osteofascial compartment syndrome[J]. Lingnan Modern Clinics in Surgery, 2015, 15(01): 111-114.

参考文献

[1]Kalyani BS, Fisher BE, Roberts CS, et al.Compartment syndrome of the forearm: a systematic review[J].J Hand Surg Am, 2011, 36(3):535-543
[2] Donaldson J, Haddad B, Khan WS.The pathophysiology, diagnosis and current management of acute compartment syndrome[J].Open Orthop J, 2014, 8:185-193
[3]Gourgiotis S, Villias C, Germanos S, et al.Acute limb compartment syndrome: a review[J].J Surg Educ, 2007, 64(3):178-186
[4]Malik AA, Khan WS, Chaudhry A, et al.Acute compartment syndrome--a life and limb threatening surgical emergency[J].J Perioper Pract, 2009, 19(5):137-142
[5]Frink M, Hildebrand F, Krettek C, et al.Compartment syndrome of the lower leg and foot[J].Clin Orthop Relat Res, 2010, 468(4):940-950
[6]Shadgan B, Menon M, Sanders D, et al.Current thinking about acute compartment syndrome of the lower extremity[J].Can J Surg, 2010, 53(5):329-334
[7]张斌, 苏伟.骨筋膜室综合征的诊疗进展[J].中国医药导报, 2008, 5(18):32-33
[8] Mabvuure NT, Malahias M, Hindocha S, et al.Acute compartment syndrome of the limbs: current concepts and management[J].Open Orthop J, 2012, 6:535-543
[9]Whitesides TE, Heckman MM.Acute compartment syndrome: update on diagnosis and treatment[J].J Am Acad Orthop Surg, 1996, 4(4):209-218
[10]Erd?s J, Dlaska C, Szatmary P, et al.Acute compartment syndrome in children: a case series in 24 patients and review of the literature[J].Int Orthop, 2011, 35(4):569-575
[11]姜雨, 王钢.筋膜室压力监测结合临床表现在急性骨筋膜室综合征诊断中的意义评价[J].中国医科大学学报, 2009, 38(12):956-957
[12]时梦猇, 刘燚, 沈海琦, 等.血清、、检测在骨筋膜室综合征早期诊治中的应用观察[J].山东医药, 2009, 49(14):11-13
[13] Harrison DK.Optical measurements of tissue oxygen saturation in lower limb wound healing[J].Adv Exp Med Biol, 2003, 540:265-269
[14]龚志锋, 沈光程, 毛琦, 等.血样饱和度监测与骨筋膜室内压测量在骨筋膜室综合征中的相关研究[J].中国骨伤, 2009, 22(5):365-366
[15]刘照宏, 梁峭嵘, 石星, 等.彩色多普勒超声诊断前臂急性骨筋膜室综合征[J].中国介入影响与治疗学, 2009, 6(6):523-526
[16]尹志良, 瞿佳, 杨益红.地震灾害伤员小腿骨筋膜室综合征的治疗[J].航空航天医药, 2009, 20(1):40-41
[17] Matsen FA, Wyss CR, Krugmire RB Jr, et al.The effects of limb elevation and dependency on local arteriovenous gradients in normal human limbs with particular reference to limbs with increased tissue pressure[J].Clin Orthop Relat Res, 1980, (150):187-195
[18]杜志军, 穆世民, 王新江, 等.负压封闭引流技术在骨筋膜室综合征中的应用[J].组织工程与重建外科杂志, 2010, 6(4):208-210
[19] 陈永健, 王志坚, 高辉, 等.有限切开负压吸引Ⅰ期缝合治疗小腿骨筋膜室综合征[J].中外医疗, 2009, (1):65-
[20]王廷凯, 李顺英, 李玉明.网状切口髓内针固定防治小腿骨折伴骨筋膜室综合征[J].中国医药导报, 2008, 5(12):34-
[21]罗志勇, 殷铭东, 袁艺, 等.微创深筋膜切开刀在早期骨筋膜室综合征的临床应用[J].武警医学, 2012, 23(7):616-618
[22]张志刚, 杨占东, 童锋.四肢骨—筋膜室综合征的治疗体会[J].吉林医药, 2010, 31(32):5803-5804
[23]邵永, 冯虎, 张允刚, 等.骨筋膜室综合征诊断与治疗失误的教训分析[J].徐州医学院学报, 2003, 23(2):165-166
[24]Elliott KG, Johnstone AJ.Diagnosing acute compartment syndrome[J].J Bone Joint Surg Br, 2003, 85(5):625-632