小腿骨筋膜室综合征的诊治与延误分析

目的总结小腿损伤并骨筋膜室综合征早期诊治方法，分析诊治延误原因。方法本组小腿损伤并骨筋膜室综合征患者33例，其中男性25例，女性8例，年龄8～66岁，平均29．7岁，密切观察临床症状和体征，及时应用whiteside针刺测压装置监测，多普勒超声血流探测仪或彩超检查确诊后即时切开减压21例，保守治疗后减压12例。结果及时减压组优良率约90．48％（19／21），保守后减压组优良率约41．67％（5／12），随访6个月至7年，平均3．3年，其中1例后期形成慢性窦道骨髓炎，2例骨不连接再次植骨加内固定而治愈，4例截肢后安装义肢，足下垂、轻度膝、踝关节僵硬4例：26例血液循环及下肢功能恢复良好。结论早期诊断、严密观察病情、及时切开减压是治疗骨筋膜室综合征的重要措施。

Analysis of early delayed diagnosis and treatment for leg of osteofascial compartment syndrome

Objective To explore the causes,diagnostic characteristics,earlier diagnosis and treatment of osteofascial compartment syndrome and analyze the reason for delayed diagnosis and treatment.Methods There were 25 males and 8 females with age range of 8~66(mean 29.7 years).The clinical symptoms and characteristics were closely observed by using Whiteside method and checked by Dopple hypersound and color hypersound.On a verified diagnosis,12 were treated with decompression posterior to conservative treatment and 21 cases with prompt open decompression.Results Of 33 cases,21 cases treated with open decompression were cured immediately,with excellence rate of 90.48%(19/21),and 12 treated with open decompression after conservative treatment obtained excellence rate of 41.67%(5/12).The follow up ranged from 6 months to 7 years(mean 3.3 years) showed that chronic myclitis of the sinus tract was seen in one case at late stage,bone ununion cured with regrafting plus internal fixation in two,artificial limbs used after amputation in four,dropfoot and slight ankylosis of knees and ankle appeared in four.Twenty-six cases won satisfactory recovery of blood circulation and lower limb function.Conclusion Early diagnosis close observation and open decompression are important for treatment of osteofascial compartment syndrome.