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膝关节脱位
原作者: Brian Corwell,葛赟译,肖锋 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2015-03-03

Title: Knee dislocation
题目:膝关节脱位
Author 作者: Brian Corwell
翻译:葛赟 校对:肖锋
Following reduction and immobilization, a thorough vascular assessment should follow. Any signs of vascular injury should prompt immediate vascular consultation (pallor, absent or diminished pulses)
在复位内固定后,应该彻底地对血管进行评估。任何血管损伤的迹象都提示应立即进行血管科会诊 (皮肤苍白,血管搏动的减弱或消失)
1) Palpate popliteal and distal pulses
1)触诊腘窝远端脉搏
2) Measure ankle-brachial index (*ABI) (<0.9 = abnormal)
2)测量踝肱指数 (* ABI) (< 0.9 = 异常)
3) Duplex ultrasound (if available)
3)多普勒超声 (如果可行的话)
*ABI – ratio of SBP in lower (DP/PT) and upper (brachial) extremities.
*ABI — — 下肢 (DP/PT) 和上肢 (肱)的 收缩压比值。
A) If strong pulses, normal ABI, and normal u/s, admit patient for observation with serial vascular examinations.
A)如果ABI 和u/s正常,但脉搏搏动强烈,则需要给病人进行一系列的血管检查。
B) If the limb is still well perfused but the pulses are asymmetric or ABI is abnormal or US is abnormal then consult vascular surgery and obtain arteriogram.
B)如果肢体血流灌注良好但是两边脉搏搏动是不对称的或者ABI、US检查不正常,那就需要请血管外科医生会诊,同时行动脉造影检查。
C) If pulses are weak or absent or distal signs of ischemic limb then obtain emergent vascular consultation for surgical repair.
C)如果脉搏搏动较弱或者消失或者远端肢体有缺血迹象,那么就需要血管外科急会诊行修复血管手术。

文章来源:《中华急诊医学杂志》编辑部