创伤严重度改良评分法在小腿骨折并发骨筋膜室综合征患者中的初步应用

Application of Revised Injury Severity Score in Lower Leg Fractures Patients with Osteofascial Compartment Syndrome

目的探讨小腿骨折并发骨筋膜室综合征(osteofascial compartment syndrome,OCS)损伤严重度的值域范围。方法采用回顾性分析方法,应用创伤严重度改良评分法(revised injury severity score,RISS)对2012-01/2016-08月收治的60例小腿骨折并发OCS患者进行量化评估,探讨其损伤严重度值域范围。结果全部病例RISS评分均在8分以上,单纯小腿部位骨折损伤患者并发OCS 12例,RISS分值在8~16分;小腿部位骨折并伴有其它部位骨折或胸腹、颅脑损伤的多发性骨创伤患者并发小腿OCS48例,RISS分值在14~28分。小腿OCS发生与RISS分值呈正相关(P<0.01)。结论合并小腿骨折的骨创伤患者的RISS值与其并发小腿OCS具有明显正相关性,当单纯小腿部位骨折损伤患者RISS值≥8分、小腿部位骨折并伴有其它部位骨折或胸腹、颅脑损伤的多发性骨创伤患者RISS值≥14分,易并发小腿OCS,应作为小腿OCS的早期重点观察对象,提高临床医生的警惕性,早期采用相应的预防措施。

Objective To explore the range of severity degree in osteofascial compartment syndrome （OCt） after lower leg fractures. Methods Sixty lower leg fractures patients with OCS were collected from January 2012 to August 2016, retrospectively analyzed and quantitatively evaluated by revised injury severity score （RISS）, meanwhile, the ran- ges of severity degree were discussed. Results The RISS were over 8 scores in all patients. Among them, the RISS of 12 patients with simple lower leg fractures were from 8 to 16 scores. Forty - eight multiple bone trauma patients, whose RISS were from 14 to 28 scores, were not only lower leg fractures but also other parts fracture or thoracoabdominal and craniocerebral injury. The OCS occurrence of lower leg were positively correlated with RISS （P〈0. 01）. Conclusion The OCS occurrence of lower leg is positively correlated with RISS. When RISS is higher than 8 in patients with simple lower leg fractures, or RISS is more than 14 in multiple bone trauma patients with lower leg fractures combined with other parts fracture or thoracoabdominal and craniocerebral injury, OCS easily become complicated. RISS should be used as an early focus for the lower leg OCS to improve the vigilance of clinicians and early use of appropriate precautions.