非手术干预在促进急性间隔综合征后功能改善方面的疗效：系统评价。
Efficacy of non-surgical interventions for promoting improved functional outcomes following acute compartment syndrome: A systematic review.
机构信息
DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, United States of America.
Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD, United States of America.
出版信息
PLoS One. 2022 Sep 9;17(9):e0274132. doi: 10.1371/journal.pone.0274132. eCollection 2022.
BACKGROUND
Acute compartment syndrome (ACS) is a devastating complication which develops following a traumatic extremity injury that results in increased pressure within osteofascial compartments, thereby leading to ischemia, muscle and nerve necrosis, and creates a life-threatening condition if left untreated. Fasciotomy is the only available standard surgical intervention for ACS. Following fasciotomy the affected extremity is plagued by prolonged impairments in function. As such, an unmet clinical need exists for adjunct, non-surgical therapies which can facilitate accelerated functional recovery following ACS. Thus, the purpose of this systematic review was to examine the state of the literature for non-surgical interventions that aim to improve muscle contractile functional recovery of the affected limb following ACS.
METHODS
English language manuscripts which evaluated non-surgical interventions for ACS, namely those which evaluated the function of the affected extremity, were identified as per PRISMA protocols via searches within three databases from inception to February 2022. Qualitative narrative data synthesis was performed including: study characteristics, type of interventions, quality, and outcomes. Risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation's (SYRCLE) RoB tool and reported level of evidence for each article.
RESULTS
Upon review of all initially identified reports, 29 studies were found to be eligible and included. 23 distinct non-surgical interventions were found to facilitate improved muscle contractile function following ACS. Out of 29 studies, 15 studies which evaluated chemical and biological interventions, showed large effect sizes for muscle function improvement.
CONCLUSIONS
This systematic review demonstrated that the majority of identified non-surgical interventions facilitated an improvement in muscle contractile function following pathological conditions of ACS.
背景
急性间隔综合征（ACS）是一种毁灭性的并发症，发生在创伤性四肢损伤后，导致骨筋膜间隔内压力增加，从而导致缺血、肌肉和神经坏死，如果不治疗则会造成危及生命的状况。筋膜切开术是 ACS 唯一可行的标准手术干预措施。筋膜切开术后，受影响的肢体功能长期受损。因此，临床上需要一种辅助的非手术治疗方法，以促进 ACS 后功能的快速恢复。因此，本系统评价的目的是检查旨在改善 ACS 后受影响肢体肌肉收缩功能恢复的非手术干预措施的文献现状。
方法
根据 PRISMA 方案，通过对三个数据库从开始到 2022 年 2 月的搜索，确定了评估 ACS 非手术干预措施的英文文献，即评估受影响肢体功能的文献。采用定性叙述性数据综合方法，包括：研究特征、干预类型、质量和结果。使用系统评价中心实验室动物实验（SYRCLE）的 RoB 工具评估偏倚风险（RoB），并报告每篇文章的证据水平。
结果
在审查了所有最初确定的报告后，发现有 29 项研究符合条件并被纳入。发现 23 种不同的非手术干预措施可以促进 ACS 后肌肉收缩功能的改善。在 29 项研究中，有 15 项评估化学和生物学干预措施的研究显示肌肉功能改善的效果显著。
结论
本系统评价表明，大多数已确定的非手术干预措施可促进 ACS 病理条件下肌肉收缩功能的改善。
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