Blaylock Roger S
Leslie Williams Memorial Hospital, Gold Fields Health Services, Carletonville, Gauteng.
S Afr J Surg. 2003 Aug;41(3):72-3.
A 15-year-old patient who had been bitten on the ankle by a snake presented with swelling extending to the chest wall, with significant haemostatic abnormalities. Compartment and femoral vessel entrapment syndromes are presented. Compartment syndrome is easily mimicked by snakebite without a compartment syndrome. Current measurement of intracompartmental pressure, diastolic or mean arterial blood pressure and resulting equations used to determine the need for fasciotomy do not take into account regional venous or arterial pressures. Combined vessel entrapment and compartment syndromes due to snakebite warrant urgent surgery once hypovolaemia and coagulopathy have been controlled.
一名15岁患者脚踝被蛇咬伤,出现肿胀蔓延至胸壁,并伴有明显的止血异常。文中介绍了骨筋膜室综合征和股血管受压综合征。蛇咬伤很容易模拟骨筋膜室综合征而实际并无该综合征。目前用于测量骨筋膜室内压力、舒张压或平均动脉血压以及用于确定是否需要进行筋膜切开术的公式并未考虑局部静脉或动脉压力。一旦控制住血容量不足和凝血病,因蛇咬伤导致的血管受压合并骨筋膜室综合征需要紧急手术。