改良小切口网状减压联合负压封闭引流术治疗骨筋膜综合征的效果分析

Analysis of the Effect of Improved Small Incision Mesh Decompression Combined with VSD Technique in the Treatment of Osteofascial Compartment Syndrome

目的探讨改良小切口网状减压联合负压封闭引流术(VSD)技术治疗骨筋膜综合征的效果。方法选择2009年3月至2011年3月廊坊市人民医院收治的33例骨筋膜综合征患者为对照组,给予皮肤大切口深筋膜切开减压术联合传统药物治疗,选择2011年4月至2014年10月收治的49例骨筋膜综合征患者为观察组,给予改良小切口网状减压联合VSD治疗。对两组患者的临床疗效、治疗前后乳酸脱氢酶(LDH)、肌酸激酶(CK)及天冬氨酸转氨酶(AST)水平、术后感染率及截肢率进行比较。结果 1治疗后观察组患者的创面缩小程度明显高于对照组,差异有统计学意义[(2.12±0.24)cm比(0.61±0.13)cm,P<0.01];观察组患者的愈合时间及住院时间均明显短于对照组,差异有统计学意义[(36.32±6.74)d比(54.25±10.11)d;(16.76±4.21)d比(25.58±6.14)d,P<0.01]。2治疗后观察组患者的LDH、CK及AST均明显低于治疗前[(131.5±34.7)U/L比(362.1±110.7)U/L;(198.6±70.1)U/L比(3892.5±504.2)U/L;(22.2±6.4)U/L比(138.2±104.7)U/L]和对照组[(220.3±45.7)U/L、(392.9±78.3)U/L、(76.2±22.4)U/L],差异有统计学意义(P<0.01)。3治疗后观察组患者的创面感染率明显低于对照组,差异有统计学意义[0.0%比18.18%(6/33),P<0.05]。结论对骨筋膜综合征患者采用改良小切口网状减压联合VSD治疗,可明显提高临床疗效,降低LDH、CK及AST水平,降低创面感染率,值得临床推广与应用。

Objective To investigate the effect of improved small incision mesh decompression combined with vacuum sealing drainage（VSD） technique in the treatment of osteofascial compartment syndrome. Methods Total of 33 patients with osteofascial compartment syndrome in Langfang City People＇s Hospital from Mar. 2009 to Mar. 2011 were treated by deep fascia incision decompression combined with traditional medicine. 49 patients with osteofascial compartment syndrome from Apr. 2011 to Oct. 2014 were treated by improved small incision mesh decompression combined with VSD technique. Clinical efficacy, the levels of lactate dehydrogenase（LDH） ,creatine kinase（CK） and aspartate transaminase（AST） ,wound infection rate and amputation rate of patients after therapy of the two groups were compared. Results （1）The reduced degree of wound area of patients in the observation group after therapy was significantly higher than that in the control group [ （2. 12 ±0. 24） cm vs （ 0. 61 ± 0. 13 ） cm, P 〈 0. 01 ]. Healing time and hospital stay of the observation group after therapy were significantly shorter than the control group [ （ 36.32 ±6. 74 ） d vs （54. 25 ± 10. 11 ） d; （ 16. 76 ± 4. 21 ） d vs （ 25.58± 6. 14） d, P 〈 0.01 ]. （2）The levels of LDH, CK and AST of the observation group after therapy were significantly lower than before treatment [ （ 131.5 ± 34. 7 ） U/L vs （362. 1 ± 110. 7 ） U/L; （ 198. 6 ±70. 1 ） U/L vs （ 3892. 5 ± 504.2 ） U/L; （22.2 ± 6.4 ） U/L vs （ 138. 2± 104. 7 ） U/L] and control group [ （ 220. 3 ± 45.7 ） U/L, （ 392.9 ± 78.3 ） U/L, （ 76.2 ± 22.4 ） U/L] （ P 〈0.01 ）. （3）The wound infection rate of the observation group after therapy was significantly lower than the control group[0. 0% vs 18. 18% （6/33） ,P 〈0. 05]. Conclusion Improved small incision mesh decompression combined with VSD technique in the treatment of osteofascial compartment syndrome can effectively improve clinical efficacy, reduce LDH, CK and AST levels, and reduce wound infection rate and amputation rate,thus is worthy of chnical appheation.