| MESS评分在治疗下肢骨折伴血管损伤中的临床意义 |
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投稿时间：2010-03-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 周飞亚 |
ZHOU Fei-ya |
温州医学院附属二院手外科,浙江 温州 325027 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
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| 郭晓山 |
GUO Xiao-shan |
温州医学院附属二院手外科,浙江 温州 325027 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
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| 高伟阳 |
GAO Wei-yang |
温州医学院附属二院骨科 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
wygao1@163.com |
| 陈星隆 |
CHEN Xin-long |
温州医学院附属二院手外科,浙江 温州 325027 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
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| 李志杰 |
LI Zhi-jie |
温州医学院附属二院手外科,浙江 温州 325027 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
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| 蒋良福 |
JIANG Liang-fu |
温州医学院附属二院手外科,浙江 温州 325027 |
Departement of Orthopaedics,the Second Hospital Affiliated to Wenzhou Medical College,Wenzhou 325027,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第6期，第445-447页 |
| DOI：10.3969/j.issn.1003-0034.2010.06.016 |
| 基金项目: |
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中文摘要:
目的：回顾性分析MESS评分在下肢骨折伴血管损伤的临床意义及可靠性。
方法：用MESS评分表对2006年3月至2008年3月收治的28例下肢骨折伴血管损伤患者进行评分，男17例，女11例；年龄23～53岁，平均38岁。其中胫腓骨上段骨折17例，股骨下端骨折7例，膝关节脱位伤4例。18例MESS评分≥7.0分，其中13例Ⅰ期截肢，5例Ⅱ期截肢；10例MESS评分<7.0分，行骨折开放复位内固定同时，取大隐静脉移植修复血管8例，直接行端端吻合术2例。
结果：18例MESS评分≥7.0分的患者均Ⅰ期或Ⅱ期截肢，10例MESS评分<7.0分的患者Ⅰ期行保肢手术，术后肢体均成活，随访0.5～1年，术后患肢运动和感觉功能恢复良好。
结论： MESS评分简单、准确，可帮助我们对下肢骨折伴血管损伤的处理制定更客观准确的治疗方案。 |
| 【关键词】下肢 骨折 修补手术,外科 血管 损伤严重度评分 截肢术 |
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| Clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries |
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ABSTRACT
Objective: To study the clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries,and to evaluate its reliance.
Methods: From March 2006 to March 2008,28 patients with fractures of lower limb combined with vascular injuries were graded by MESS scoring system. There were 17 patients were male and 11 patients were female,ranging in age from 23 to 53 years,averaged 38 years. Seventeen patients had fractures at the superior segment of tibia and fibia,7 patients had fractures at the inferior segment of femur, and other 4 patients had dislocation of knee joint. Among the patients,18 patients had MESS scores more than 7.0 point,in which 13 patients were treated with one-stage amputation,5 patients were treated with two-stage amputation；the other 10 patients had the MESS scores less than 7.0 point,and were treated with open reduction and internal fixation,in which 8 patients were treated with transplantation of great saphenous vein to repair blood vessles,and 2 patients were treated with vascular end to end anastomosis.
Results: Among the patients,including 18 patients whose MESS scores more than 7.0 point were treated with one-stage or two-stage amputation,and 10 patients whose MESS scores less than 7.0 point were treated with limb salvage operations,all the limbs survived. During the follow-up period(ranged from 0.5 to 1 year,the movement and sensory function of the limbs recovered well.
Conclusion: MESS is a simple and reliable tool to determine the proper strategy for the patients suffering from vascular injuries with fractures. |
| KEY WORDS Lower extremity Fractures Revision,surgical Blood vessels Injury severity score Amputation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 周飞亚,郭晓山,高伟阳,陈星隆,李志杰,蒋良福.MESS评分在治疗下肢骨折伴血管损伤中的临床意义[J].中国骨伤,2010,23(6):445~447 |
| 英文格式: | ZHOU Fei-ya,GUO Xiao-shan,GAO Wei-yang,CHEN Xin-long,LI Zhi-jie,JIANG Liang-fu.Clinical significance of MESS scoring system in the treatment of fractures of lower limb combined with vascular injuries[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(6):445~447 |
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