心脏及大血管手术后并发骨筋膜室综合征的临床分析  

Clinical analysis of acute compartment syndrome after cardiovascular surgery

作　　者：仲维佳[1] 刘张章[2] 徐博[3] 张京岚[1] ZHONG Weijia LIU Zhangzhang XU Bo ZHANG Jinglan(Department of SICU , Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseaes , Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所综合外科监护,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所骨科,100029 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所体外循环及机械辅助科,100029

出　　处：《心肺血管病杂志》2017年第8期658-661,691,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究分析心脏及大血管手术后并发骨筋膜室综合征的临床特点,提高对本病的认识。方法:回顾性分析安贞医院2009年1月至2016年5月,心脏及大血管手术后发生骨筋膜室综合征患者的临床资料。结果:首发症状均为患侧小腿肿胀、组织张力高,伴有皮肤发花、发绀等肢体缺血表现。升主动脉+主动脉全弓人工血管置换术组患者术后症状出现早。患者普遍预后差。结论:骨筋膜室综合征是心脏及大血管手术后一种非常罕见的并发症,危险因素多,起病隐匿。早期临床诊断、改善患肢循环、及时行手术减压,对患者的临床预后、生活质量等都有重要意义。Objective： To analysis the clinical characteristics of Acute compartment syndrome after cardiovascular surgery,and to deepen the understanding of this disease. Methods： Retrospective the clinical datas of patients undergoing the acute compartment syndrome after cardiac and aortic surgery from Jan. 2009 to May. 2016 in Beijing Anzhen Hospital. Results： The initial symptoms of all the patients are calf swelling and tense on the affected side,with the signs of limbs ischemia,like pallor,cyanosis. Compared with the patients undergoing coronary artery bypass graft,patients who take the Bentall ＋ Sun＇s surgery present the symptoms earlier. Patients are generally with poor prognosis. Conclusion： Acute compartment syndrome is an extremely rare complication after cardiovascular surgery,with multiply pathogenic factors,and is difficult to diagnosis at the onset. Early diagnosis to increase the blood supply on affected limbs,and timely operations make great significance to the prognosis and life quality of life.

关 键 词：骨筋膜室综合征 筋膜室内压 体外循环 体外膜肺氧合 主动脉球囊反搏 

分 类 号：R54[医药卫生—心血管疾病]