摘要
目的：探讨氧自由基（OFR）清除剂防治骨筋膜室综合征（OCS）的临床疗效。方法：对2001年3月-2004年12月收治的23例OCS患者应用下列OFR清除剂：①20％甘露醇注射液250ml，30min内静脉滴注；②复方丹参注射液20ml（或川芎嗪注射液160mg）、七叶皂苷钠20mg、维生素C注射液4．0g分别加入5％葡萄糖或生理盐水注射液250ml中静脉滴注，每分钟约60滴（4ml）。上述药物首次4h内滴完，用药后动态测定骨筋膜室压力。大于30mmHg时立即切开深筋膜减压，小于30mmHg（或切开减压术后）继续应用上述药物5～7d，每天1次。其中20％甘露醇根据肿胀程度调整为125～250ml，6h或8h1次。同时维持液体轻度负平衡状态及电解质平衡，预防感染，支持治疗。结果：经6～24个月随访，23例应用OFR清除剂治疗后17例痊愈。因入院较晚，6例切开深筋膜减压后3例痊愈，3例伤残。总有效率86．9％。结论：创伤早期应用OFR清除剂可以明显减轻四肢再灌注损伤，降低OCS的发生率及伤残率。
Objective：To explore the clinical effect of antioxidants for the prevention and cure of OCS （osteofascial compartment syndrome）. Methods： From May 2001 to December 2004, 23 patients with were treated with antioxidants： （1）Using 20 % Mannitol 250 ml intravenous drip in 30 minutes. （2）Salvia Miltiorrhiza 20 ml（or ligastraxzini 160 mg）, Sodium aescinate 20 mg and Vitamin C 4.0 g were respectively dissolved in 5% dextrose or saline 250 ml, which were injected by intravenous drip（60 drips per minute）. The above-mentioned drugs were used in 4 h at first, then the muscular osteofascial compartment pressure was measured with dynamic method. If the pressure was more than 30 mmHg, fasciotomy was performed at once. These drugs were used 5 - 7 days（one time per day） when the pressure was less than 30 mmHg or after fasciotomy. 20% Marmitol was used 125 - 250 ml according to swelling degree（one time per 6 - 8 h）, keeping the negative fluid balance infection and electrolytes balance, preventing infection and holding out treatment. Results：After treatment with OFR scavenger,all patients were followed up from 6 to 12 months. 17 cases obtained excellent. 6 cases with late hospitalization were treated with fasciotomy,of them, 3 cases obtained excellent, 3 cases disabled. The total effective rate was 86.9 %. Conclusion： In early injury, using OFR scavenger was effective to reduce the ischemia and reperfusion injury, decrease the incidence rate of OCS and invalidity rate.
出处
《中国骨伤》
CAS
2006年第1期20-21,共2页
China Journal of Orthopaedics and Traumatology
关键词
骨筋膜室综合征
抗氧化剂
Osteofascial compartment syndrome（OCS）
Antioxidants
作者简介
通讯作者；付常国Tel；0371—68058680
