土耳其地震中因长时间受压导致挤压伤后的筋膜切开术。
Fasciotomy in crush injury resulting from prolonged pressure in an earthquake in Turkey.
作者信息
Duman H, Kulahci Y, Sengezer M
机构信息
Gulhane Military Medical School, Department of Plastic and Reconstructive Surgery, Etlik, Ankara, Turkey.
出版信息
Emerg Med J. 2003 May;20(3):251-2. doi: 10.1136/emj.20.3.251.
OBJECTIVES
The authors report on the patients treated in a clinic who were injured in the earthquake that took place in north western part of Turkey in 1999 and was reported to be measured at 7.4 on the Richter scale. This catastrophe killed over 16 000 people while injuring more than 23 000 people. The type of housing was varied and entrapment occurred in single, two or more storey buildings.
METHODS
35 patients were admitted to the plastic surgery department after the earthquake. The hospital is about 400 km from the disaster site. Although all the transported victims had intravenous lines, few had adequate volume replacement. Sixteen had an urgent fasciotomy at the time of admission. The procedures were performed between 8 and 21 hours after extrication. After fasciotomy, all non-viable muscle content was removed but an attempt was made to retain as much viable muscle as possible.
RESULTS
Amputation was required on four patients (25%). Fasciotomy incisions were closed with skin grafting in eight cases, and with primary closure in four cases.
CONCLUSION
Prompt fasciotomy in earthquake victims will be both life saving and can prevent some of the severe and dangerous complications after crush syndrome.
目的
作者报告了在一家诊所接受治疗的患者情况，这些患者在1999年发生于土耳其西北部的地震中受伤，据报道该地震里氏震级为7.4级。这场灾难导致16000多人死亡，23000多人受伤。房屋类型多样，被困情况发生在单层、两层或更多层建筑中。
方法
地震后35名患者被收治到整形外科。医院距离灾难现场约400公里。尽管所有转运来的受害者都有静脉输液管，但很少有人得到足够的容量补充。16人在入院时接受了紧急筋膜切开术。手术在救出后8至21小时内进行。筋膜切开术后，所有无活力的肌肉组织均被切除，但尽量保留尽可能多的有活力的肌肉。
结果
4名患者（25%）需要截肢。8例筋膜切开切口采用植皮闭合，4例采用一期缝合。
结论
对地震受害者及时进行筋膜切开术既能挽救生命，又能预防挤压综合征后的一些严重和危险并发症。
Zotero 插件