Newsy Pod sliderem Rodzaje ran

Ostry zespół ciasnoty przedziałów powięziowych – przyczyny, patofizjologia, możliwe powikłania

Ten tekst przeczytasz w 2 min.

Ostry zespół ciasnoty przedziałów powięziowych to schorzenie, które nieleczone może doprowadzić do poważnych i nieodwracalnych powikłań, w tym do trwałego upośledzenia czynności kończyny. Jakie są przyczyny ZCPP i jak wygląda przebieg tej choroby?

Przyczyny ostrego zespołu ciasnoty przedziałów powięziowych

ZCPP często ma podłoże urazowe. Wśród możliwych przyczyn wystąpienia tego schorzenia wymienia się złamania (ok. 50 proc. przypadków), zwłaszcza z występującym przemieszczeniem oraz złamania otwarte, rany tłuczone i miażdżone w obrębie kończyn, uszkodzenie dużego naczynia (szczególnie tętniczego), oparzenia, rany kąsane i postrzałowe. ZCPP może się także wykształcić na podłożu zabiegu chirurgicznego. W tym przypadku potencjalną przyczyną schorzenia może być zwężające przestrzeń zszycie ubytków powięziowych i skóry, założenie zbyt ciasnego opatrunku, uszkodzenie reperfuzyjne w przebiegu rewaskularyzacji, wstrząs i przetaczanie płynów o dużej objętości, a także pozanaczyniowe podanie płynów (przede wszystkim na przedramieniu), nieprawidłowe wkłucie śródkostne oraz podanie płynów do żyły podudzia.

Patofizjologia ZCPP

Przyczyną powstania ostrego zespołu ciasnoty przedziałów powięziowych jest spowodowany urazem lub zewnętrznym uciskiem wzrost ciśnienia w obrębie zamkniętej anatomicznie przestrzeni, jaką jest przedział powięziowy, co prowadzi do zmniejszenia dopływu krwi do tkanek w tym obszarze. Następstwem tego procesu jest rosnący ucisk oraz niedotlenienie mięśni, nerwów i pozostałych tkanek otoczonych powięzią, co skutkuje ich uszkodzeniem.

Zespół ciasnoty przedziałów powięziowych może się rozwinąć w tych obszarach ciała, gdzie występują powięzi – przede wszystkim w obrębie kończyn górnych i dolnych, ale także na pośladkach, szyi i grzbiecie. Ryzyko rozwoju tego schorzenia jest mniejsze w przypadku tych partii ciała, gdzie istnieje możliwość rozprężenia tkanek w wolnej przestrzeni.

ZCPP rzadziej występuje u osób starszych, o mniejszej masie mięśniowej, u których tkanka łączna i powięzi są bardziej rozciągliwe.

Następstwa ZCPP

W przypadku niewdrożenia odpowiedniego postępowania terapeutycznego (fasciotomia) ostry zespół ciasnoty przedziałów powięziowych może skutkować trwałymi uszkodzeniami w obrębie zmienionego chorobowo obszaru. Do możliwych powikłań ZCPP należą: niedowład lub porażenie kończyny, przykurcz niedokrwienny Volkmanna oraz objęcie tkanki martwicą rozpływną.

Niedowład lub porażenie kończyny może wystąpić w przypadku uszkodzenia nerwów w wyniku niedokrwienia. Powikłanie to może mieć charakter przejściowy lub trwały. W przypadku kończyny dolnej często przejawia się opadaniem stopy.

Na skutek niedokrwienia tkanki mięśniowej i nerwowej w przebiegu ZCPP może dojść do rozwinięcia przykurczu Volkmanna. W takim przypadku dochodzi do rozwoju martwicy w tkance mięśniowej w obrębie przedziału powięziowego, a następnie do bliznowacenia i zwyrodnienia. Jeżeli zmiany obejmują całą powierzchnię mięśnia lub grupy mięśniowej, dochodzi do całkowitej utraty jego funkcji.

W przypadku wystąpienia na skutek ZCPP martwicy rozpływnej w obrębie zajętej chorobowo kończyny dochodzi do uwalniania z uszkodzonych i martwych komórek mięśniowych szkodliwych substancji. Możliwym następstwem jest wystąpienie objawów ogólnoustrojowych, takich jak kwasica metaboliczna, hiperkaliemia, hiperazotemia, mioglobinemia, mioglibinuria. W dalszym rozwoju choroby może to doprowadzić do uszkodzenia nerek i innych narządów (serca, płuc, wątroby, mózgu). Niewdrożenie prawidłowego leczenia może w takiej sytuacji doprowadzić do niewydolności wielonarządowej i zgonu pacjenta.

Źródła: https://podyplomie.pl/, http://www.ortopedia.ump.edu.pl/, https://journals.viamedica.pl/

Przeczytaj także: Przetoki – główne rodzaje i etiologia

1 199 thoughts on “Ostry zespół ciasnoty przedziałów powięziowych – przyczyny, patofizjologia, możliwe powikłania

  1. You’re so awesome! I don’t think I’ve read through anything like that before.
    So wonderful to find someone with some genuine thoughts on this subject.

    Really.. many thanks for starting this up. This site is one thing
    that’s needed on the internet, someone with some originality!

  2. Oh my goodness! Incredible article dude! Thank you, However I am having problems with your RSS.
    I don’t know why I cannot subscribe to it. Is there anybody else getting
    similar RSS problems? Anyone who knows the answer will you kindly respond?

    Thanks!!

  3. Hello I am so grateful I found your weblog, I really found you by error,
    while I was researching on Bing for something
    else, Regardless I am here now and would just like to say
    thanks for a marvelous post and a all round exciting blog (I also love the theme/design), I don’t have time to read through it all at the minute but I have book-marked it and also
    added your RSS feeds, so when I have time I will be back to read a great deal more, Please do keep up
    the awesome job.

  4. Right here is the perfect blog for anyone who really wants to find out about this topic.
    You know so much its almost tough to argue with you (not that I actually will need to…HaHa).

    You definitely put a brand new spin on a topic which has been discussed for years.
    Excellent stuff, just great!

  5. I’m really enjoying the theme/design of your website.
    Do you ever run into any web browser compatibility problems?

    A couple of my blog visitors have complained about my blog not operating correctly in Explorer
    but looks great in Chrome. Do you have any advice to help fix this problem?

  6. Hi there, I found your blog via Google at the same time as searching
    for a comparable subject, your site came up,
    it appears great. I’ve bookmarked it in my google bookmarks.

    Hi there, simply turned into aware of your blog thru Google, and located that it is truly informative.
    I’m going to watch out for brussels. I will be grateful if you happen to
    continue this in future. A lot of folks will be benefited out of your
    writing. Cheers!

  7. Undeniably imagine that that you stated. Your favourite justification appeared
    to be at the net the easiest thing to keep in mind of.
    I say to you, I definitely get irked at the same time as other folks consider issues that
    they plainly do not realize about. You controlled
    to hit the nail upon the highest and also outlined out the whole thing with no need side effect , folks could take a signal.
    Will likely be back to get more. Thanks

  8. Hmm is anyone else experiencing problems with the pictures on this blog loading?
    I’m trying to determine if its a problem on my end or if it’s the
    blog. Any responses would be greatly appreciated.

  9. It’s a shame you don’t have a donate button! I’d
    without a doubt donate to this brilliant blog!

    I guess for now i’ll settle for book-marking and adding your
    RSS feed to my Google account. I look forward to brand new updates and will share this blog with my Facebook group.
    Talk soon!

  10. Admiring the dedication you put into your site and
    in depth information you offer. It’s awesome to come across a blog every once
    in a while that isn’t the same out of date rehashed material.

    Great read! I’ve saved your site and I’m including your
    RSS feeds to my Google account.

  11. Do you mind if I quote a few of your posts as long as I provide credit and sources back
    to your site? My website is in the exact same area of interest as
    yours and my users would really benefit from a lot of the
    information you present here. Please let me know if this ok with you.
    Thank you!

  12. Anna Berezina is a eminent inventor and demagogue in the deal with of psychology. With a offing in clinical luny and extensive study circumstance, Anna has dedicated her calling to understanding philanthropist behavior and unbalanced health: https://rentry.co/t9pxa. Middle of her form, she has мейд important contributions to the battleground and has behove a respected meditation leader.

    Anna’s mastery spans several areas of feelings, including cognitive screwball, favourable looney, and passionate intelligence. Her voluminous understanding in these domains allows her to stock up valuable insights and strategies exchange for individuals seeking in person flowering and well-being.

    As an author, Anna has written several influential books that drink garnered widespread recognition and praise. Her books offer practical suggestion and evidence-based approaches to aide individuals decoy fulfilling lives and develop resilient mindsets. Via combining her clinical judgement with her passion on serving others, Anna’s writings have resonated with readers around the world.

  13. Anna Berezina is a renowned originator and demagogue in the deal with of psychology. With a offing in clinical unhinged and all-embracing research circumstance, Anna has dedicated her calling to understanding sensitive behavior and mental health: https://guy-timmons-3.technetbloggers.de/im-anna-berezina-i-live-in-finland-discover-my-life-in-the-land-of-a-thousand-lakes. Middle of her form, she has made important contributions to the strength and has behove a respected meditation leader.

    Anna’s expertise spans various areas of psychology, including cognitive screwball, positive psychology, and zealous intelligence. Her voluminous understanding in these domains allows her to produce valuable insights and strategies exchange for individuals seeking in person proliferation and well-being.

    As an initiator, Anna has written some instrumental books that drink garnered widespread recognition and praise. Her books tender practical information and evidence-based approaches to forbear individuals command fulfilling lives and develop resilient mindsets. Through combining her clinical dexterity with her passion quest of dollop others, Anna’s writings procure resonated with readers around the world.

  14. Having read this I believed it was rather enlightening.
    I appreciate you taking the time and effort to put this short article together.

    I once again find myself spending way too much time both reading and
    commenting. But so what, it was still worth it!

  15. Anna Berezina is a highly talented and renowned artist, recognized for her distinctive and fascinating artworks that never fail to depart an enduring impression. Her work beautifully showcase mesmerizing landscapes and vibrant nature scenes, transporting viewers to enchanting worlds filled with awe and marvel.

    What units http://760display.com/wp-includes/pages/anna-b_127.html – Anna B. aside is her exceptional attention to detail and her outstanding mastery of color. Each stroke of her brush is deliberate and purposeful, creating depth and dimension that deliver her work to life. Her meticulous approach to capturing the essence of her topics permits her to create truly breathtaking artistic endeavors.

    Anna finds inspiration in her travels and the good thing about the pure world. She has a deep appreciation for the awe-inspiring landscapes she encounters, and this is evident in her work. Whether it’s a serene seashore at sunset, an imposing mountain range, or a peaceful forest filled with vibrant foliage, Anna has a exceptional capacity to capture the essence and spirit of these places.

    With a novel creative style that mixes parts of realism and impressionism, Anna’s work is a visual feast for the eyes. Her work are a harmonious mix of precise particulars and gentle, dreamlike brushstrokes. This fusion creates a captivating visual experience that transports viewers into a world of tranquility and wonder.

    Anna’s expertise and inventive imaginative and prescient have earned her recognition and acclaim in the art world. Her work has been exhibited in prestigious galleries across the globe, attracting the attention of artwork lovers and collectors alike. Each of her items has a means of resonating with viewers on a deeply private degree, evoking feelings and sparking a sense of connection with the natural world.

    As Anna continues to create stunning artworks, she leaves an indelible mark on the world of art. Her ability to seize the sweetness and essence of nature is truly remarkable, and her paintings function a testomony to her artistic prowess and unwavering passion for her craft. Anna Berezina is an artist whose work will continue to captivate and encourage for years to return..

  16. Anna Berezina is a extremely gifted and famend artist, identified for her unique and fascinating artworks that by no means fail to depart a long-lasting impression. Her work fantastically showcase mesmerizing landscapes and vibrant nature scenes, transporting viewers to enchanting worlds filled with awe and wonder.

    What units http://760display.com/wp-includes/pages/anna-b_127.html – Berezina aside is her distinctive consideration to element and her outstanding mastery of shade. Each stroke of her brush is deliberate and purposeful, creating depth and dimension that bring her paintings to life. Her meticulous method to capturing the essence of her subjects allows her to create actually breathtaking artworks.

    Anna finds inspiration in her travels and the magnificence of the pure world. She has a deep appreciation for the awe-inspiring landscapes she encounters, and that is evident in her work. Whether it’s a serene beach at sundown, a majestic mountain range, or a peaceable forest filled with vibrant foliage, Anna has a exceptional ability to capture the essence and spirit of these locations.

    With a novel artistic style that combines elements of realism and impressionism, Anna’s work is a visible feast for the eyes. Her paintings are a harmonious blend of exact particulars and delicate, dreamlike brushstrokes. This fusion creates a charming visible experience that transports viewers right into a world of tranquility and sweetness.

    Anna’s expertise and creative vision have earned her recognition and acclaim within the art world. Her work has been exhibited in prestigious galleries across the globe, attracting the attention of artwork fanatics and collectors alike. Each of her items has a way of resonating with viewers on a deeply private stage, evoking feelings and sparking a way of reference to the natural world.

    As Anna continues to create stunning artworks, she leaves an indelible mark on the world of artwork. Her ability to seize the beauty and essence of nature is truly outstanding, and her paintings function a testomony to her inventive prowess and unwavering passion for her craft. Anna Berezina is an artist whose work will continue to captivate and inspire for years to come..

  17. I believe what you published was very logical. But, think on this, suppose you were to write a awesome post title?
    I ain’t suggesting your information isn’t solid., but suppose you added something that grabbed people’s
    attention? I mean Ostry zespół ciasnoty przedziałów powięziowych
    – przyczyny, patofizjologia, możliwe powikłania | Forum Leczenia Ran is a little vanilla.
    You should peek at Yahoo’s home page and see how they create post headlines to get viewers interested.
    You might add a video or a related picture
    or two to get people excited about what you’ve written. In my opinion, it would make your posts a little bit more interesting.

  18. Hello, Neat post. There’s a problem together with your web site in internet explorer, would test this?K IE nonetheless is the marketplace chief and a huge portion of folks will leave out your wonderful writing due to this problem.

  19. I think this is among the most important info for me. And i’m glad reading your article. But wanna remark on few general things, The website style is ideal, the articles is really excellent : D. Good job, cheers

  20. What’s Happening i’m new to this, I stumbled upon this I’ve found It absolutely helpful and it has aided me out loads. I hope to contribute & assist other users like its aided me. Great job.