胫腓骨骨折并骨筋膜室综合征的早期炎症反应

目的探讨胫腓骨骨折并骨筋膜室综合征早期的炎症反应程度。方法将40例胫腓骨骨折并骨筋膜室综合征的患者按患者受伤时间进行分组：A组（20例）为受伤6 h以内切开减压患者,B组（20例）为受伤6 h后切开减压患者。在受伤后第1、3、5、7、9、11、14天抽血测定C反应蛋白（CRP）;取脂肪、渗出液、筋膜及肌肉组织作细菌培养并采用ELISA法测定肿瘤坏死因子（TNF）、白介素6（IL-6）的含量。结果 40例患者CRP、TNFI、L-6含量均明显升高,以伤后第7天前后含量最高,均升高约11%,直至第11天后才下降;A、B 2组各测定值含量差异无统计学意义（P〉0.05）。结论创伤应激后可出现CRP、TNFI、L-6含量明显升高,可作为衡量早期炎症水平的标准;为降低感染应在急症或伤后9 d以后手术。

Early Inflammatory Response in Osteofascial Compartment Syndrome Associated with Tibia and Fibula Fracture

Objective To explore the early inflammatory response in osteofascial compartment syndrome associated with tibia and fibula fracture.Methods Forty patients with osteofascial compartment syndrome associated with tibia and fibula fracture were divided into two groups,with 20 patients in each group.Open decompression was performed within the first 6 hours of injury in group A and 6 hours after injury in group B.C-reactive protein（CRP） blood levels were measured at 1,3,5,7,9,11 and 14 days after injury.At the same time,the fat,effusion,fascia and muscle tissue were obtained for bacterial culture,and TNF and IL-6 were measured using ELISA.Results The levels of CRP,TNF and IL-6 increased significantly,with the greatest increase at 7 days after injury（11%）,and then decreased on day 11.No statistical diferences were found in the levels of CRP,TNF and IL-6 between the two groups（P0.05）.Conclusion The levels of CRP,TNF and IL-6 are significantly higher after injury and can be used as a standard to measure the early inflammation.The operation should be performed on the first day or after 9 days to reduce the infection.