Cone Jennifer, Inaba Kenji
Trauma and Acute Care Surgery, LAC+USC Medical Center, Los Angeles, California, USA.
Trauma Surg Acute Care Open. 2017 Sep 14;2(1):e000094. doi: 10.1136/tsaco-2017-000094. eCollection 2017.
Lower extremity compartment syndrome is a devastating complication if not rapidly diagnosed and properly managed. The classic symptoms of compartment syndrome can be deceiving as they occur late. Any concern for compartment syndrome based on mechanism, or the presence of pain in the affected extremity, should prompt a compartment pressure check. Both absolute compartment pressures above 30 mm Hg and a pressure differential of less than 30 mm Hg are used to make the diagnosis. The treatment goal is first to save the patient's life and second to salvage the affected limb. Fasciotomy is the only accepted treatment of compartment syndrome and should be performed quickly after the diagnosis is made. Outcomes after fasciotomy are best when there is no delay in treatment.
下肢骨筋膜室综合征若不能迅速诊断并妥善处理,将是一种极具破坏性的并发症。骨筋膜室综合征的典型症状出现较晚,可能具有欺骗性。基于受伤机制或患肢疼痛而对骨筋膜室综合征产生任何疑虑时,均应进行骨筋膜室内压力检查。骨筋膜室内绝对压力高于30 mmHg以及压力差小于30 mmHg均可用于诊断。治疗目标首先是挽救患者生命,其次是保全患肢。筋膜切开术是骨筋膜室综合征唯一被认可的治疗方法,确诊后应尽快实施。若治疗不延迟,筋膜切开术后的效果最佳。