汶川地震伤致筋膜室综合征发病部位及早期诊疗分析

目的 分析地震伤致骨筋膜室综合征(OCS)的发病部位及早期诊治方法.方法 2008年5月12日发生的汶川地震所致OCS伤员67例,男性38例,女性29例,年龄8～69岁,平均38.1岁.其中合并胫腓骨折34处,合并股骨骨折9处,合并肱骨骨折4处,合并尺桡骨骨折13处,合并手足骨折各有1处.OCS的发病部位包括小腿41处,大腿25处,手2处,足3处,臀部19处,前臂15处以及上臂10处.密切观察临床症状和体征,确诊后即时切开减压.结果 全部115处骨OCS中,82处经二期缝合,创口愈合、血供恢复、功能满意,23处经二期缝合、植皮后创面愈合,5处因肢体缺m坏死而截肢,另有2例患者(含5处OCS)死亡.结论 地震中OCS的罕见发病部位比例升高.早期诊断、严密观测、及时切开减压是治疗OCS的重要措施.

Analysis of the location, early diagnosis and treatment of osteofascial compartment syndrome resulted from Wenchuan earthquake

Objective To analyze the location, early diagnosis and treatment of osteofascial compartment syndrome (OCS).Methods There were 38 males and 29 females with age range of 8 -69 years( mean 38.1 years).All 67 cases were suffered from Wenchuan earthquake happened in May 12th, 2008, of which 34 focuses with tibiafibular fracture, 9 focuses with femoral fracture, 4 focuses with humorus fracture, and 13 focuses with radius and/or ulna fracture.The occurred place of OCS involves calf(41 focuses), legs (25 focuses) ,hands(2 focuses) ,feet(3 focuses) , hip ( 19 focuses) , forearms( 15 focuses) and upperarms (10 focuses).The clinical symptoms and characteristics were closely observed and treated with decompression posterior to conservative treatment or with prompt open decompression.Results Of 67 cases (115 focuses), 82 focuses with secondary suture won satisfactory recovery of blood circulation and extremity function, 23 wounds were closed with secondary suture and skin grafting, 5 limbs were amputated due to avascular necrosis and 2 cases died (5 focuses OCS).Of 115 focuses I I focuses obtain part function, 7 focuses lost join function.Conclusions The proportion of some rare parts' pathogenesis of osteofascial compartment syndrome caused by the earthquake rises. Early diagnosis, close observation and open decompression are important for treatment of osteofascial compartment syndrome.