不同平面腘动脉损伤血清肌酸激酶动态变化的临床特点

doi:10.13418/j.issn.1001-165x.2021.02.015

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (2): 196-201.doi: 10.13418/j.issn.1001-165x.2021.02.015

不同平面腘动脉损伤血清肌酸激酶动态变化的临床特点

毛剑杰¹，　高建明^1,2

1.安徽医科大学无锡临床学院，合肥 230000； 2.中国人民解放军联勤保障部队第904医院，江苏无锡 214000

收稿日期:2020-08-07 出版日期:2021-03-25 发布日期:2021-04-08
通讯作者: 高建明，教授，硕士生导师，E-mail：gjmgw65070698101@sina.com
作者简介:毛剑杰（1993-），男，浙江绍兴人，在读硕士，医师，主要研究方向：骨科和显微外科，E-mail：1360161689@qq.com
基金资助:
中国人民解放军第一0一医院院管科研课题基金（2018YG07）

Clinical characteristics of dynamic changes of serum creatine kinase in popliteal artery injury in different planes

Mao Jianjie¹, Gao Jianming^1，2

1.Wuxi Clinical College, Anhui Medical University, Wuxi 214000, Jiangsu Province, China; 2. Department of Orthopedics, The 904 Hospital of the Joint Service Support Force of Chinese PLA, Wuxi 214000, Jiangsu Province, China

Received:2020-08-07 Online:2021-03-25 Published:2021-04-08

摘要/Abstract

摘要： 目的　探讨不同平面腘动脉损伤致患肢创伤严重程度的临床意义，评估腓肠动脉在腘动脉创伤修复中的作用。方法　收集2010年1月~2019年12月收治的单侧膝关节周围骨折（含脱位）患者103例。其中，合并腘动脉损伤患者68例，根据损伤平面是否高于腓肠动脉分为高位组（16例）和低位组（52例）；其余35例为对照组。对比分析3组患者术前、术后1、3、7、15 d肌酸激酶（creatine kinase，CK）。结果　高位组CK值显著大于低位组，低位组大于对照组（F=217.709，P<0.001）；同一时间点（术前、术后1、3、7、15 d）3组患者CK值两两比较均有明显差异（P<0.001)。高位组CK各时间点比较均有统计学差异（P<0.05）；低位组术前与术后7 d（P=0.930）、术后1 d与术后3 d（P=0.195）比较无统计学差异。结论　高位组患肢缺血、损伤程度重于低位组；腓肠动脉是腘动脉不同损伤平面CK差异的主要原因，具有代偿作用。

关键词: 腘动脉, 　创伤, 　腓肠动脉, 　血清肌酸激酶

Abstract: Objective　To investigate the clinical significance about the severity of trauma to the affected limb caused by popliteal artery injury at different levels, to evaluate the role of sural artery in repair of popliteal artery trauma.　Methods　One hundred and three patients with unilateral knee fracture (dislocation) who were admitted to our hospital from January 2010 to December 2019 were collected. Sixty-eight patients with popliteal artery injury were divided into a high group (n=16) and a low group (n=52) according to whether the injury level was higher than the sural artery or not, the remaining 35 patients were in a control group. The CK (creatine kinase) of three groups before operation and 1 day, 3 days, 7days, 15 days after operation were compared and analyzed.　Results　CK value in the high group was significantly higher than that in the low group, while the low group was higher than the control group (F=217.709, P<0.001). There were significant differences in CK value among the three groups at the same time point (before operation, 1 day, 3 days, 7 days 15 days after operation) (P<0.001). There were statistical differences in CK value at each time point in the high group (P<0.05); there were no statistical differences in CK value between before operation and 7 days after operation (P=0.930), 1 day and 3 days after operation (P=0.195) in the low group.　Conclusions　The degree of limb ischemia and injury in the high group is more serious than that in the low group. The sural artery is the main reason for CK difference at different injury planes of popliteal artery, and it has a compensatory effect.

Key words: Popliteal artery, 　Trauma, 　Sural artery, 　Creatine kinase

中图分类号:

R641

毛剑杰, 高建明. 不同平面腘动脉损伤血清肌酸激酶动态变化的临床特点[J]. 中国临床解剖学杂志, 2021, 39(2): 196-201.

Mao Jianjie, Gao Jianming. Clinical characteristics of dynamic changes of serum creatine kinase in popliteal artery injury in different planes[J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 196-201.

参考文献 19

[1]	Guice JL, Gifford SM, Hata K, et al. Analysis of limb outcomes by management of concomitant vein injury in military popliteal artery trauma[J]. Ann Vasc Surg, 2020, 62: 51-56. DOI: 10.1016/j.avsg.2019.05.007.
[2]	Keeley J, Koopmann M, Yan H, et al. Factors aAssociated with amputation following popliteal vascular injuries[J]. Ann Vasc Surg, 2015, 29(5): 881-882. DOI: 10.1016/j.avsg.2015.03.030.
[3]	Lang NW, Joestl JB, Platzer P. Characteristics and clinical outcome in patients after popliteal artery injury[J]. J Vasc Surg, 2015, 61(6): 1495-1500. DOI: 10.1016/j.jvs.2015.01.045.
[4]	Ramdass MJ, Muddeen A, Harnarayan P, et al. Risk factors associated with amputation in civilian popliteal artery trauma[J]. Injury, 2018, 49(6): 1188-1192. DOI: 10.1016/j.injury.2018.04.028.
[5]	田小宁, 晁杲, 从飞, 等. 腘血管不同平面损伤的临床意义[J]. 中国矫形外科杂志, 2019, 27(12): 1097-1101. DOI: 10.3977/j.issn.1005-8478.2019.12.09.
[6]	Siddiqui MK, Veluchamy A, Maroteau C, et al. CKM Glu83Gly is associated with Blunted creatine kinase variation, but not with myalgia[J]. Circ Cardiovasc Genet, 2017, 10(4): e001737. DOI: 10.1161/CIRCGENETICS.117.001737.
[7]	Deng QY, Tang BH, Xue C, et al. Comparison of the ability to predict mortality between the injury severity score and the new injury severity score: a meta-aAnalysis[J]. Int J Environ Res Public Health, 2016, 13(8): 1-12. DOI: 10.3390/ijerph13080825.
[8]	Hohenberger GM, Konstantiniuk P, Cambiaso-Daniel Janos, et al. The mangled extremity severity score fails to be a good predictor for secondary limb amputation after trauma with vascular injury in central europe[J]. World J Surg, 2020, 44(3): 773-779. DOI: 10.1007/s00268-019-05263-w.
[9]	Kumar RS, Singhi PK, Chidambaram M. Are we justified doing salvage or amputation procedure based on mangled extremity severity score in mangled upper extremity injury[J]. J Orthop Case Rep, 2017, 7(1):3-8. DOI: 10.13107/jocr.2250-0685.662.
[10]	梁超, 赵睿, 臧成五, 等. 胶原阵列微管神经支架修复指神经缺损的初步临床研究[J]. 中华手外科杂志, 2019, 35(2): 103-106. DOI: 10.3760/cma.j.issn.l 005-054X.2019.02.008.
[11]	Liu CY, Li CD, Wang L, et al. Function scores of different surgeries in the treatment of knee osteoarthritis: a PRISMA-compliant systematic review and network-meta analysis[J]. Medicine (Baltimore), 2018, 97(21): 1-11. DOI: 10.1097/MD.0000000000010828.
[12]	Sowards KJ, Mukherjee K, Norris PR, et al. Elevated serum creatine phosphokinase is associated with mortality and inotropic requirement in critically injured adults[J]. Injury, 2014, 45(12): 2096-2100. DOI: 10.1016/j.injury.2014.09.009.
[13]	Simpson JP, Taylor A, Sudhan N, et al. Rhabdomyolysis and acute kidney injury: creatine kinase as a prognostic marker and validation of the McMahon Score in a 10-year cohort: a retrospective observational evaluation[J]. Eur J Anaesthesiol, 2016, 33(12): 906-912. DOI: 10.1097/EJA. 0000000000000490.
[14]	Byerly S, Benjamin E, Biswas S, et al. Peak creatinine kinase level is a key adjunct in the evaluation of critically ill trauma patients[J]. Am J Surg, 2017, 214(2): 201-206. DOI: 10.1016/j.amjsurg.2016.11.034.
[15]	Keeley J, Koopmann M, Yan H, et al. Factors associated with amputation after popliteal vascular injuries[J]. Ann Vasc Surg, 2016, 33: 83-87. DOI: 10.1016/j.avsg.2016.02.004.
[16]	Mullenix PS, Steele SR, Andersen CA, et al. Limb salvage and outcomes among patients with traumatic popliteal vascular injury: an analysis of the National Trauma Data Bank[J]. J Vasc Surg, 2006, 44(1): 94-100. DOI: 10.1016/j.jvs.2006.02.052.
[17]	Vasquez CR, Disanto T, Reilly JP, et al. Relationship of body mass index, serum creatine kinase, and acute kidney injury after severe trauma[J]. J Trauma, 2020, 89(1): 179-185. DOI: 10.1097/TA.00000 00000002714.
[18]	Patterson BM, Agel J, Swiontkowski MF, et al. Knee dislocations with vascular injury: outcomes in the Lower Extremity Assessment Project (LEAP) Study[J]. J Trauma, 2007, 63(4): 855-858. DOI: 10.1097/TA.0b013e31806915a7.
[19]	Talving P, Karamanos E, Skiada D, et al. Relationship of creatine kinase elevation and acute kidney injury in pediatric trauma patients[J]. J Trauma, 2013, 74(3): 912-916. DOI: 10.1097/TA.0b013e318278954e.

不同平面腘动脉损伤血清肌酸激酶动态变化的临床特点

Clinical characteristics of dynamic changes of serum creatine kinase in popliteal artery injury in different planes

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