急性骨筋膜室综合征的危险因素及早期诊断

Risk factor and early diagnosis of acute osteofascial compartment syndrome

目的比较急性骨筋膜室综合征(AOCS)发生、发展的相关危险因素,为其预防、早期诊断和治疗提供必要参考。方法整理总结我院临床确诊AOCS及Volkman’s挛缩患者275例患肢308处,对患者年龄、性别、损伤原因、部位、处理方法及疗效等相关因素作流行病学分析统计。结果在人群中,AOCS的发生、发展及结局与患者的年龄、性别、损伤原因、部位有一定关系。⑴受伤原因:作业碾轧伤占38.55%,交通意外损伤RTA占33.45%;⑵受伤部位:前臂149处(48.38%),小腿103处(33.44%);⑶性别:男性228例(82.91%),女性47例(17.09%),男性远多于女性;⑷年龄:0～10岁组64例(23.27%),11～20岁组69例(25.09%),21～30岁组63例(22.91%),31～40岁组50例(18.18%),40岁以下青年人中占89.46%。结论统计数据表明,40岁以下的年轻人,尤其是男性,其四肢受到与骨折相关的高能性伤和组织挤压伤时极易发生急性骨筋膜室综合征,是其发病的高危人群。

Objective To compare the associated factors of acute osteofascial compartment syndrome(AOCS), and provide the reference for its diagnosis and treatment. Methods We have Analysed the common condition of 275 AOCS patients treated in our orthopedic department during 1983 to 2003.Results In the group,the occurrence of AOCS was associated with four points:age,sex,injury-cause and injuried part of the body. Young men who were usually under 40 years old,with high energy injuries in forearm and lower leg,were in the risk group.(1)Causes of injury: tissue-crushing with fracture in work was 38.55 percent,followed by traffic accident was 33.45 percent(RTA). All of them are high-energy-injury and tissue-crushing injury.(2) injuried part of body:AOCS which had taken place in forearm was 149 patients(48.38%),and in leg was 103 patients(33.44%).(3) sex factor:228 patients(82.91%) was men while 47 patients(17.09%) was women.(4) age factor: 66 patients was in 0-10 years old(23.27%),69 patients was in 11-20 years old(25.09%),63 patients was in 21-30 years old(22.91%),50 patients was in 31-40 years old(18.18%). All of them was 89.46 percent. Conclusion The data show that the people who is a man under 40 years old,with high-energh-injury and tissue-crushing injury in forearm and leg was at high risk of AOCS.