烧后手腕道综合征:一个系统的审查
Thomas Albert1, Pierre Perrot2, Flore-Anne Lecoq1
1Institut de la Main - Nantes Atlantique - Bd Charles-Gautier, 44800 Saint-Herblain, France.
Hand surgery & rehabilitation
|March 24, 2025
概括
烧伤后手腕道综合征经常被忽视,导致治疗延迟和显著的功能损失. 早期诊断和手术干预对于治疗中枢神经损伤至关重要.
科学领域:
- 神经学 神经学
- 烧伤手术 烧伤手术
- 康复医学 康复医学 康复医学
背景情况:
- 烧伤后神经病变,特别是手腕道综合征 (CTS),是一种未被认可的并发症,影响手腕中枢神经.
- 电气和热烧伤是常见的原因,影响年轻人,主要是男性人口,长时间住院和诊断延迟.
研究的目的:
- 审查关于在烧伤后发生的手腕中介神经单元神经病变的具体管理的文献.
- 介绍一个烧伤受害者的案例研究,该受害者患上了CTS并接受了手术治疗.
主要方法:
- 在Cochrane图书馆,PubMed和EMBASE进行了系统的文献搜索.
- 包括集中在中枢神经受伤后烧伤的研究;不包括那些不针对中枢神经或涉及早期释放的研究.
- 一个23岁的男性患有电烧引起的CTS的病例被介绍,详细介绍了手术前后的评估.
主要成果:
- 审查了13篇文章,主要涉及电气/热烧伤 (2-65%的TBSA).
- 诊断延迟的平均时间为137.5天; 电肌图并未持续使用,并且没有超声波/MRI等先进成像.
- 该案例研究显示,手术后握力中度改善,感觉恢复,功能评分中度改善,电诊断恢复不完全.
结论:
- 在烧伤患者中推迟诊断和治疗CTS可能会导致严重的功能缺陷.
- 早期的临床和电诊断评估对于及时的手术干预至关重要,以防止不可逆转的神经损伤.
- 超声波可能有助于早期诊断和识别替代病因; 提出了用于管理与烧伤相关的CTS的决策算法.
相关概念视频
01:26Flail Chest-II
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
01:29Assessment of the Cardiovascular System II: Inspection
Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Head and Neck
01:27Assessment of the Cardiovascular System III: Palpation
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
01:29Cardiovascular System Abnormal Findings I: Inspection and Palpation
In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during an inspection
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...