摘要
目的 :通过扩髓与非扩髓髓内钉术中小腿后深间室压力观察 ,比较两者对小腿筋膜间室压力的影响。方法 :闭合复位交锁髓内钉治疗胫骨骨折 3 3例。扩髓组 17例 ,非扩髓组 16例。记录麻醉后牵引前、牵引后、术前、进钉、锁钉、锁钉后、手术后小腿后深间室压力。扩髓组记录插导针、依次扩髓时的压力。健肢在麻醉后、术后测压对比。结果 :受伤后肢体的后深间室压力均大于健侧肢体 (P <0 .0 5 ) ,扩髓时小腿后深间室压力急剧升高 (3 3～ 10 9mmHg)。扩髓后压力有所下降 ,但进钉时由升高至最高峰 (3 1～ 114mmHg)。非扩髓组进钉时小腿后深间室压力相比较小。髓内钉进入髓腔后锁钉时 ,扩髓组压力比非扩髓组压力低 (无统计学差异 )。术后小腿后深间室压力都下降至接近术前。结论 :虽然闭合复位、髓内钉插入、扩髓时会导致小腿筋膜间室压力增高 ,但是短暂的。同时扩髓与非扩髓对小腿筋膜间室压力的影响基本一致 。
Objective:To observe the changes of the deep posterior compartment pressure (DPCP) during the reamed and nonreamed nailing.Methods:33 tibial intramedullary nailing which 17 reamed and 16 nonreamed were observed the deep posterior compartment pressure (DPCP) at the time on postanaesthesia,reduction by traction,pre nailing,nailing,after locking of nail,and postoperation.In the reamed group,this was also done during insertion of the guide wire and reaming.The pressure were also monitored on the contralateral leg after the anathessia and after the operation.Results:The DPCP on the wounded legs was higher than the unwounded side with a statistical difference( P <0.05).The pressure was increased during the time of reaming (33～109mmHg).Although the pressure decreased after the reaming ,it went up again to the peak during nailing (31～114mmHg).The DPCP of the nonreamed group was lower than the reamed group but there was no statistical difference.After the nailing and during the locking,the pressure decreased more rapidly on reamed group than that on the nonreamed.The pressure on both the nonreamed and reamed groups dropped to the level same as that before the operation.Conclusion:Although the pressure is higher during reduction,reaming,nailing,the authors think it is temporary.There is no statistical difference between the two methods of nailing on the influence of DPCP.
出处
《中国矫形外科杂志》
CAS
CSCD
2002年第8期779-781,共3页
Orthopedic Journal of China
