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題名 | Compartment Syndrome after High-Pressure Paint Gun Injection Injury to the Hand--A Case Report=手部高壓油漆噴槍噴射傷後導致腔室症候群--個案報告 |
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作者 | 張子彥; 李曜洲; 李璧蓉; 邱浩遠; Chang, Tzu-yen; Lee, Yao-chou; Lee, Pi-jung; Chiu, Haw-yen; |
期刊 | 臺灣整形外科醫學會雜誌 |
出版日期 | 20140900 |
卷期 | 23:3 2014.09[民103.09] |
頁次 | 頁259-265 |
分類號 | 416.615 |
語文 | eng |
關鍵詞 | 腔室症候群; 手指; 高壓油漆噴槍; High-pressure; Compartment syndrome; |
中文摘要 | 背景:手部高壓油漆噴槍噴射傷是一種罕見且常被低估的創傷,當發生在手部時更是一種經常導致截肢或失能的災難性傷害。目的及目標:本篇個案報告強調此種傷害發生時,早期清創及警覺腔室症候群以及早進行筋膜切開術佔有重要的治療角色。材料及方法:一位49歲女性不慎將油漆噴入左手掌,我們儘快給予早期清創。然而前臂仍逐漸腫脹合併小指發疳的發生。在警覺腔室症候群發生後,我們緊急施行筋膜切開術,但是發現兩邊指動脈都因為廣泛栓塞而無法重新建立血液循環。因此我們藉由盡可能保持軟組織及手背皮膚的完整性,並且於術後輔以抗血栓藥物來嘗試挽救小指。結果:小指重新獲得血循並且最後存活,和正常指比較起來的動作範圍保留住至少百分之86。結論:雖然工業安全的進步使得高壓油漆噴槍噴射傷的比例似乎已經下降,我們仍須強調早期清創、警覺腔室症候群以及時進行筋膜切開術是挽救手指最重要的條件。 |
英文摘要 | Background: High-pressure paint gun injection injury is rare but often underestimated. Injury to the hand is devastating and frequently leads to amputation or loss of function. Aim and Objectives: This case report emphasized the role of early debridement and prompt fasciotomy for compartment syndrome in the treatments for high-pressure paint gun injection injury. Material and methods: A 49-year-old woman suffered from high-pressure paint gun injection injury to her left palm. Early debridement was performed promptly. However, progressive swelling to the forearm level and cyanotic change of the little finger developed. Emergency fasciotomy was performed under the impression of compartment syndrome. Intraoperatively, we found the digital arteries were both extensively thrombosed making them infeasible to be revasculaized. We tried to salvage this digit by preserving as much soft tissue and dorsal skin as possible followed by anticoagulation treatments. Results: Her left little finger regained circulation gradually and survived eventually. The range of motion recovered to 86% as compare with her right hand counterpart. Conclusion: Though the improvements in occupational safety decrease the occurrence of high-pressure paint gun injury to the hand, it still cannot be overemphasized that early debridement and fasciotomy for compartment syndrome are essential to salvage the digits after this kind of injury. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。