Stanford A型主动脉夹层术后下肢骨筋膜室综合征的治疗

The management of lower limb compartment syndrome after surgical treatment with Stanford type A aortic dissection

目的分析下肢切开减压和封闭式负压引流治疗Stanford A型主动脉夹层术后下肢骨筋膜室综合征的效果。方法急性Stanford A型主动脉夹层术后发生下肢骨筋膜室综合征患者9例。本组患者主动脉手术后明确诊断下肢骨筋膜室综合征,即行下肢皮肤切开减压,对切开的创面进行封闭式负压引流,并辅以药物或肾替代治疗。结果死亡2例,病死率22.2%,存活的7例病人中,5例患者待肌肉肿胀消退后缝合切口,术后未出现明显并发症。结论下肢皮肤切开减压并使用封闭式负压引流是治疗Stanford A型主动脉夹层术后发生下肢骨筋膜室综合征有效方法。

Objective To evaluate the efficacy of fasciotomy and vacuum sealing drainage on management of lower limb compartment syndrome after surgical treatment with Stanford type A aortic dissection.Methods A retrospective analysis was conducted on 9 cases of lower limb compartment syndrome after surgical treatment with Stanford type A aortic dissection in our hospital.Fasciotomy and vacuum sealing drainage were applied.Medicine and continuous renal replacement therapy were also used.Results By these treatments,7 cases were healed without postoperative complications.The other 2 cases died of vital organ failure.The case fatality rate is 22.2%（2/9）.Conclusion Fasciotomy and vacuum sealing drainage were effective methods in managing lower limb compartment syndrome after surgical treatment with Stanford type A aortic dissection.