筋膜切开术在下肢血管伤中的作用

目的　探讨筋膜切开术在下肢血管伤中的作用。方法　对 1985年～ 1998年间 5 2例下肢血管伤中 ,2 0例采用小腿筋膜切开术。结果　 2 0例下肢筋膜切开术患者中 (筋膜切开率占 38% ) ,双侧切口筋膜切开 18例 (90 % ) ,单侧切口筋膜切开 2例(10 % ) ,平均 15d闭合伤口。肢体成活率占 80 % (16例 ) ,截肢率 2 0 % (4例 ) ,缺血性挛缩发生率 10 % (2例 )。随访时间 6个月～ 5年 (平均 2 5年 ) ,优良率 75 % (9例功能优 ,3例功能良 )。结论　在下肢血管伤中 ,筋膜切开术是提高肢体成活率 ,降低死亡率和缺血性挛缩发生率的重要辅助性手术

The Role of Fasciotomy in Vascular Injuries of the Lower Limbs

Objective To investigate the role of fasciotomy in vascular injuries of the lower limbs.Methods Fasciotomy was performed in 20 cases from 52 cases of vascular injuries of the lower limbs over a 14 year period.Results Twenty(38%)fasciotomies were performed.Double-incision fasciotomy was used in 18(90%)extremities,single-incision fasciotomy was used in 2(10%).An average of 15 days after surgery,fasciotomies were closed.The limb salvage rate was 80%(16 patients),the amputation rate was 20%(4 patients),the Volkmann's ischaemia rate was 10%(2 patients).During the follow-up period of 6 months to 5 years(an average of 2.5 years),the excellent and good rate was 75%(excellent in 9 patients,good in 3 patients).Conclusions The fasciotomy is very important assistant operation to raise the limb salvage rate and to reduce death rate and Volkmann's ischaemia rate in vascular injuries of lower limbs.