地震伤骨筋膜室综合征伤员酶学指标监测分析

Monitoring of enzymatic indicators in patients with osteofascial compartment syndrome of limbs caused by earthquake

目的初步探讨外周血酶学指标在骨折合并骨筋膜室综合征(CS)早期诊断及治疗中的临床意义。方法从地震受伤后入院开始,连续7天测肌钙蛋白(TPI)、肌红蛋白(Mb)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH),单纯胫腓骨折与骨折合并CS进行上述测量指标分组比较分析。结果骨折合并CS患者入院后TPI、Mb、CK、CK-MB、LDH较正常值成倍升高,与单纯骨折患者比较具有显著差异性,切开减压术后总体呈下降趋势,但仍维持在较高水平。结论酶学指标的监测对骨折合并CS的早期诊断、病情评估具有重要临床意义。

Objective To preliminarily study the clinical effect of enzymological indicators of peripheral blood in diagnosing and treating the osteofascial compartment syndrome in leg caused by earthquake.Methods Patients were divided into simple tibiofibular fracture group and fracture combined with compartment syndrome group.Troponin,myoglobin,creatinkinase,creatine kinase-MB isoenzyme,lactate dehydrogenase were detected for 7 days and compared between two groups since admission.Results There was a prominent increase in troponin,myoglobin,creatinkinase,creatine kinase-MB isoenzyme,lactate dehydrogenase in fracture combined with compartment syndrome group.After performing open decompression,the indicators decreased,while they were still at high level.Conclusion Monitoring of enzymological indicators has important clinical significance in the early diagnosis and assessment of patients with fracture combined with compartment syndrome.