急性四肢症候群の診断と治療
Arvind G von Keudell1, Michael J Weaver2, Paul T Appleton3
1Orthopedic Trauma Initiative at Harvard Medical School, Boston, MA, USA.
Lancet (London, England)
|October 14, 2015
まとめ
末端における急性コンパートメント症候群 (ACS) の診断は依然として困難です. このレビューはデータを要約し,診断と治療を改善し,重度の肢体合併症を予防するための臨床ガイドラインを提案しています.
科学分野:
- 整形外科
- 緊急 医療
- トラウマ 手術
背景:
- 末の急性コンパートメント症候群 (ACS) は診断に困難を伴う.
- 遅延または不適切な治療は,重度の永久的な肢体損傷または喪失につながる可能性があります.
- 末端ACSの最適な診断方法については,現在コンセンサスがありません.
研究 の 目的:
- 大人と子供の急性四肢症候群に関する現在のデータをレビューする.
- 急性コンパートメント症候群の 病理生理学について
- 急性四肢症候群の診断と管理のための臨床ガイドラインを提案する.
主な方法:
- 急性末症候群に関する利用可能なデータの体系的なレビュー
- 病理生理学の分析
- 証拠に基づいた臨床ガイドラインの作成
主要な成果:
- 多くの研究にもかかわらず 診断は困難です
- 対照的な外科的アプローチは,早期の外科的介入と対照的に,継続的な室内圧力のモニタリングです.
- 外科的断層切除は 圧力を軽減しますが 長期的な合併症の危険性があります
結論:
- 手足の急性コンパートメント症候群の診断に関する明確なコンセンサスは欠けている.
- 臨床ガイドラインの提案は,診断と管理を標準化することを目的としています.
- 効果的な診断と 適時な介入は 壊滅的な結果を防ぐために 極めて重要です
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