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上臂急性骨筋膜室综合征:2例报告

Acute compartment syndrome of the upper arm: a report of 2 cases.

作者信息

Antebi Alon, Herscovici Dolfi

机构信息

Orthopedic Surgery, Orthopedic Trauma Service, Tampa General Hospital, Tampa, Florida, USA.

出版信息

Am J Orthop (Belle Mead NJ). 2005 Oct;34(10):498-500.

Abstract

Compartment syndromes of the upper arm are rare clinical entities but can be a serious problem, especially in unconscious patients or those presenting with altered mental status. A high index of suspicion is needed to make an accurate diagnosis. Measuring compartment pressures is helpful, but the role of pressure measurement in the diagnosis and treatment may be secondary to the clinical examination. In patients presenting without histories of trauma, who have sustained long periods of immobilization, a suspicion of a crush syndrome should also be included during the workup of a compartment syndrome. Fasciotomy and débridement of necrotic and nonviable tissue are the treatments of choice for a patient with a compartment syndrome, but initiating medical management and providing medical stability for systemic complications resulting from a crush syndrome may be necessary prior to surgical intervention to prevent organ failure and death. Overall, prognosis is improved by early diagnosis and treatment.

摘要

上臂骨筋膜室综合征是罕见的临床病症,但可能是一个严重问题,尤其是在无意识患者或精神状态改变的患者中。需要高度怀疑指数才能做出准确诊断。测量骨筋膜室内压力是有帮助的,但压力测量在诊断和治疗中的作用可能次于临床检查。对于没有创伤史但长期固定的患者,在骨筋膜室综合征的检查过程中也应怀疑挤压综合征。对于骨筋膜室综合征患者,筋膜切开术以及对坏死和无活力组织的清创是首选治疗方法,但在手术干预之前,可能有必要启动医疗管理并为挤压综合征引起的全身并发症提供医疗稳定性,以防止器官衰竭和死亡。总体而言,早期诊断和治疗可改善预后。

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