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246 9 |
Ultima descărcare din IBN: 2023-12-17 17:59 |
Căutarea după subiecte similare conform CZU |
616.137.83/.93-005.4-08 (2) |
Patologia sistemului circulator, a vaselor sanguine. Tulburări cardiovasculare (978) |
SM ISO690:2012 PREDENCIUC, Alexandru, CULIUC, Vasile, CASIAN, Dumitru. The role of fasciotomy for compartment syndrome in patients with acute limb ischemia. In: Revista de Ştiinţe ale Sănătăţii din Moldova, 2022, nr. 3 An.1(29), p. 307. ISSN 2345-1467. |
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Revista de Ştiinţe ale Sănătăţii din Moldova | ||||||
Numărul 3 An.1(29) / 2022 / ISSN 2345-1467 | ||||||
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CZU: 616.137.83/.93-005.4-08 | ||||||
Pag. 307-307 | ||||||
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Introduction. Compartment syndrome (CS) is a typical complication of acute limb ischemia (ALI) with an incidence of 20-30%. Fasciotomy is a single effective treatment for CS. Aim. Evaluation of factors associated with development of CS as well as of impact of early fasciotomy upon the results of revascularization. Methods. During 2019-2021 periods 142 consecutive patients supposed to revascularization for ALI were prospectively enrolled and followed-up for 3 months. CS was suspected clinically and confirmed by measuring intra-compartmental (> 30 mm Hg) or perfusion (< 20 mm Hg) pressure. In all cases, the forehead-to-foot temperature gradient (ΔT) was determined. In all patients with CS fourcompartment fasciotomy was performed simultaneously with revascularization. Results. CS was diagnosed and treated in 23 patients. Patients with CS were more frequently diagnosed with grade IIB ALI – 20 (86.9%) vs. 63 (52.9%) cases in patients without CS (p < 0.01) and had higher level of myoglobin: 443.2 ± 345 vs. 169.2 ± 284 ng/ml (p<0.05). The most significant difference was found in the rate of limbs with ΔT > 10°C: 16 (69.5%) in group with CS vs. 30 (25.2%) in control one (p < 0.0001). Temperature gradient was independently associated with presence of CS in multivariable analysis: OR 9.8 (1.1-29.4). During the follow-up in entire cohort, major amputation was registered in 21.1% cases and death – in 17.6%, without significant difference between compared groups. Conclusion. Early diagnosis and treatment of compartment syndrome can mitigate its negative impact upon the outcomes of treatment of acute limb ischemia. Forehead-to-foot temperature gradient can be used as an adjunct for clinical diagnosis of compartment syndrome. |
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Cuvinte-cheie fasciotomy, compartment syndrome, acute limb ischemia, fasciotomie, sindrom de compartiment, ischemie acută a extremităților |
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