不同处理方式预防严重胫骨平台骨折后骨筋膜室综合征的效果比较

Effect of different process model on the compartment syndrome prevention after serious fracture of tibial plateau

目的比较3种不同处理方式对预防严重胫骨平台骨折后骨筋膜室综合征的效果。方法将90例严重胫骨平台骨折患者随机分为3组，小腿按压组患者30例给予小腿静脉按压，冰袋冷敷组患者30例给予冰袋冷敷，对照组30例进行常规护理，3组患者入院后均给予常规脱水剂快速静脉滴注。比较3组效果。结果在骨筋膜室综合征的发生率、张力性水疱、1周内皮肤皱褶方面冰袋冷敷组与对照组比较差异有统计学意义（1比4，3比9，22比15；X2值分别为4．284，3．822，3．875；P〈0．05），小腿按压组与对照组比较差异也有统计学意义（0比4，2比9，23比15；χ2值分别为4．784，5．986,4．593；P〈0．05）；而冰袋冷敷组与小腿按压组之间差异无统计学意义（χ2值分别为0．005，0．215，0．085；P〉0．05）。结论早期局部冰袋冷敷和小腿静脉按压均能减轻软组织的肿胀，预防骨筋膜室综合征发生。

Objective To compare the effect of three different process models on the compartment syndrome prevention after serious fracture of tibial plateau. Methods Totals of 90 cases with serious fracture of tibial plateau were randomly divided into three groups, with 30 cases every group, crus press group received the intervention of leg vein press, cold packs group received the cold packs intervention, and the control group received the traditional nursing care. M1 the patents received the rapid intravenous drip of dehydrant. Results The incidence of compartment syndrome, tension sex blisters, skin folds in one week of cold packs group was significantly different with that of control group （ 1 vs 4,3 vs 9,22 vs 15 ;χ2 = 4.284,3. 822,3. 875, respectively; P 〈 0.05）, and between crus press group and control group, the difference was statistically significant （0 vs 4,2 vs 9,23 vs 15 ;χ2 = 4.784,5. 986,4. 593 ,respectively;P 〈 0.05 ）,while there was no significantly difference between cold packs group and crus press group（P 〉 0.05）. Conclusions The process model of leg vein press and cold packs early can alleviate the swell of soft tissue of patients with fracture of tibial plateau, so as to prevent the compartment syndrome occurring.