中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2012年
10期
872-875
,共4页
筋膜间隔综合征%引流术%功能恢复%改良Whiteside法
觔膜間隔綜閤徵%引流術%功能恢複%改良Whiteside法
근막간격종합정%인류술%공능회복%개량Whiteside법
Compartment syndromes%Drainage%Functional recovery%Modified Whiteside method
目的 探讨骨筋膜间室综合征(OCS)的早期诊断方法及迅速、有效的临床治疗方法. 方法 2007年1月至2008年12月共收治16例OCS患者,均为男性;年龄15～55岁,平均32岁.OCS部位:小腿部12例,足部4例.全部患者均无血管神经损伤.采用改良Whiteside法测量筋膜间室内压力,切开减压使用负压封闭引流(VSD)技术治疗.肿胀基本消退后,创面予以直接缝合或创面植皮术,以及根据骨折部位和特点,行骨折内固定术.术后根据Merchant评分标准分别从患肢关节功能、疼痛程度、步态、关节稳定度和活动范围等方面评定疗效. 结果 16例患者术后获12～14个月(平均13个月)随访.切开减压应用VSD技术治疗后切口或创面均获愈合,14例恢复佳,患肢远端运动、感觉恢复正常;1例远端感觉减退、麻木;1例出现肌挛缩、感觉麻木、肢体功能活动障碍.根据Merchant评分标准评定疗效:优9例,良5例,可2例,优良率为87.5％. 结论 采用改良Whiteside法测定筋膜间室压力是早期诊断OCS的可靠方法;切开减压联合VSD技术可迅速并有效治疗OCS,降低患肢致残率.
目的 探討骨觔膜間室綜閤徵(OCS)的早期診斷方法及迅速、有效的臨床治療方法. 方法 2007年1月至2008年12月共收治16例OCS患者,均為男性;年齡15～55歲,平均32歲.OCS部位:小腿部12例,足部4例.全部患者均無血管神經損傷.採用改良Whiteside法測量觔膜間室內壓力,切開減壓使用負壓封閉引流(VSD)技術治療.腫脹基本消退後,創麵予以直接縫閤或創麵植皮術,以及根據骨摺部位和特點,行骨摺內固定術.術後根據Merchant評分標準分彆從患肢關節功能、疼痛程度、步態、關節穩定度和活動範圍等方麵評定療效. 結果 16例患者術後穫12～14箇月(平均13箇月)隨訪.切開減壓應用VSD技術治療後切口或創麵均穫愈閤,14例恢複佳,患肢遠耑運動、感覺恢複正常;1例遠耑感覺減退、痳木;1例齣現肌攣縮、感覺痳木、肢體功能活動障礙.根據Merchant評分標準評定療效:優9例,良5例,可2例,優良率為87.5％. 結論 採用改良Whiteside法測定觔膜間室壓力是早期診斷OCS的可靠方法;切開減壓聯閤VSD技術可迅速併有效治療OCS,降低患肢緻殘率.
목적 탐토골근막간실종합정(OCS)적조기진단방법급신속、유효적림상치료방법. 방법 2007년1월지2008년12월공수치16례OCS환자,균위남성;년령15～55세,평균32세.OCS부위:소퇴부12례,족부4례.전부환자균무혈관신경손상.채용개량Whiteside법측량근막간실내압력,절개감압사용부압봉폐인류(VSD)기술치료.종창기본소퇴후,창면여이직접봉합혹창면식피술,이급근거골절부위화특점,행골절내고정술.술후근거Merchant평분표준분별종환지관절공능、동통정도、보태、관절은정도화활동범위등방면평정료효. 결과 16례환자술후획12～14개월(평균13개월)수방.절개감압응용VSD기술치료후절구혹창면균획유합,14례회복가,환지원단운동、감각회복정상;1례원단감각감퇴、마목;1례출현기련축、감각마목、지체공능활동장애.근거Merchant평분표준평정료효:우9례,량5례,가2례,우량솔위87.5％. 결론 채용개량Whiteside법측정근막간실압력시조기진단OCS적가고방법;절개감압연합VSD기술가신속병유효치료OCS,강저환지치잔솔.
Objective To investigate an early diagnostic method and a rapid efficient treatment method to teat osteofascial compartment syndrome (OCS). Methods From January 2007 through December 2008,16 male patients with OCS were treated in our department.They were aged from 15 to 55 years (average,32 years).Twelve patients had OCS at the leg and 4 at the foot.All patients had no vascular or nerval injury.The modified Whiteside method was used to measure the pressue of the osteofascial compartment.All patients were treated with open decompression and vacuum sealing drainage (VSD).After swelling subsided,the wounds were directly sutured,decompresively sutured or treated with skin grafting. Merchant scoring was used to evaluate the postoperative efficacy in terms of limb-affected function,pain,gait,joint function,joint stability and range of motion. Results All patients were followed up for 12 to 14 months (average,13 months).All incisions closed up.Fourteen patients obtained excellent recovery of the function and sensation of the distal limb-affected; one patient had hypoesthesia and numbness at the the distal limb-affected; one patient had contracture,numbness and functional disturbance.By the Merchant scoring system,9 cases were excellent,5 good and 2 fair,giving a good to excellent rate of 87.5％. Conclusions The modified Whiteside method used to meausre the interstitial pressure is a reliable early diagnostic method for OCS.Decompression plus VSD may lead to rapid and efficient treatment of OCS and a reduced disability rate of the limb-affected.
