P. Agrawal, M. Girish, A. Ramanathan, M. Sudhakaran, S. Murali
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引用次数: 0
摘要
背景筋膜室综合征是急性创伤情况下不同形式损伤后的一种潜在肢体威胁疾病,可能导致不可逆损伤甚至生命危险。其不同的时间限制临床表现,加上对现有侵入性和非侵入性诊断方式的观察者偏见,影响了对肢体保留手术早期干预的决策和不当延误。结果32例患者入组,平均年龄36岁;男性(18;56.3%)受伤率高于女性(14;43.8%)和左肢(17;53.1%)参与多于正确(15;46.9%)。小腿总损伤肢体肌肉测量值与即刻相关的平均值为39.9 cm, 1小时后为40.69 cm, 2小时后为41.06 cm, 3小时后为41.40 cm;95%置信区间有统计学意义。3例(9%)患者接受了紧急减压筋膜切开术,损伤肢体平均为41.4 cm,而对照组平均为38.5 cm。结论筋膜室综合征是一种急性急症,若不及时诊断,可能造成不可逆的损害。诊断偏差围绕观察者技能和临床侵入性和非侵入性方法而发展,与急诊筋膜切开术决策相关的差异统计结果。
Compartment Syndrome and Its Validation in Skeletal Injuries
Abstract Background Compartment syndrome, a potential limb-threatening condition in acute traumatic situations following different modalities of injury, may lead to irreversible damage or even life risk later. Its differential time-bound clinical presentation with added observer bias on available invasive and noninvasive diagnostic modalities influences the decision-making and undue delay for early intervention toward limb salvage procedure. Results Thirty-two patients were included in our study with mean age of 36; males (18; 56.3%) were more injured than females (14; 43.8%) and left limb (17; 53.1%) was more involved than right (15; 46.9%). Mean calf muscle measurement of total injured limb with relation to immediate time was 39.9 cm, after 1 hour was 40.69 cm, after 2 hours was 41.06 cm, and after 3 hours was 41.40 cm; 95% confidence interval was found to be statistically significant. Three patients (9%) underwent emergency decompression fasciotomy, with an average mean of 41.4 cm for injured limbs against 38.5 cm in control limb. Conclusion Compartment syndrome is an acute emergency with potential irreversible damage when undiagnosed. Bias on diagnosis evolves around observer skills and clinical invasive and noninvasive methods, with differential statistical results pertaining to its decision-making for emergency fasciotomy.