Roberts R S, Csencsitz T A, Heard C W
Clin Orthop Relat Res. 1985 Mar(193):184-8.
The treatment of pit viper envenomation by fasciotomy continues to be controversial because elevated intracompartment pressures have never been previously documented. Two patients with severe pit viper envenomation of the thumb had signs and symptoms of elevated intracompartment pressures. Elevated intracompartment tissue pressures were documented in both cases. Immediate fasciotomies were necessary to decompress the thenar and forearm compartments and, in one case, the upper arm as well. Ischemic tissues were noted at the time of the operation and confirmed the clinical and objective tissue pressure measurements of compartment syndromes. Both patients made complete functional recoveries following delayed primary closure. Intracompartment pressure monitoring should be routinely used in the management of pit viper envenomation to avoid disastrous sequellae.
通过筋膜切开术治疗蝰蛇咬伤仍然存在争议，因为此前从未记录到骨筋膜室内压力升高的情况。两名拇指被蝰蛇严重咬伤的患者出现了骨筋膜室内压力升高的体征和症状。在这两个病例中均记录到骨筋膜室内组织压力升高。立即进行筋膜切开术对于减压鱼际和前臂筋膜室是必要的，在一个病例中还包括上臂。手术时发现了缺血组织，这证实了骨筋膜室综合征的临床和客观组织压力测量结果。两名患者在延迟一期缝合后均实现了完全功能恢复。在蝰蛇咬伤的治疗中应常规使用骨筋膜室内压力监测，以避免灾难性后遗症。
