van den Brand Johan G H, Verleisdonk Egbert J M M, van der Werken Christian
Department of General Surgery, University Medical Center & Central Military Hospital, Utrecht, the Netherlands.
Am J Sports Med. 2004 Mar;32(2):452-6. doi: 10.1177/0363546503261733.
Patients with chronic exertional compartment syndrome (CECS) experience pain during exercise. An abnormal increase in intracompartmental pressure (ICP) leads to impaired local tissue perfusion resulting in ischemia and pain. At cessation of exercise, pain subsides. Diagnosis is confirmed through postexercise ICP. Near infrared spectroscopy (NIRS) can measure tissue oxygen saturation (StO(2)) noninvasively.
NIRS can diagnose CECS by showing tissue deoxygenation.
Prospective, nonrandomized clinical trial.
Volunteers completed a standardized exercise protocol. Those suspected of CECS did so preoperatively and postoperatively. StO(2) and ICP were monitored. Data were compared between volunteers and patients and prefasciotomy and postfasciotomy.
Significant differences between the StO(2) values of volunteers and patients with CECS were found. Average peak exercise StO(2) value for those with CECS was lower than for the healthy (27 versus 56, P <.05). Patients showed more absolute and percentage change between baseline and peak exercise StO(2) (absolute: 60 versus 35, P <.05; percentage: 67 versus 38, P <.05). StO(2) values in legs with confirmed CECS returned to normal range postfasciotomy. All changes differed significantly with preoperative values.
StO(2) can distinguish healthy from diseased legs. This study provides evidence supporting NIRS as a noninvasive, painless alternative to ICP in the diagnosis of CECS.
慢性运动性骨筋膜室综合征（CECS）患者在运动时会经历疼痛。骨筋膜室内压力（ICP）异常升高会导致局部组织灌注受损，进而引起缺血和疼痛。运动停止时，疼痛会缓解。通过运动后ICP来确诊。近红外光谱（NIRS）可以无创测量组织氧饱和度（StO₂）。
NIRS可通过显示组织脱氧来诊断CECS。
前瞻性、非随机临床试验。
志愿者完成标准化运动方案。疑似CECS的患者在术前和术后进行该方案。监测StO₂和ICP。对志愿者与患者之间以及筋膜切开术前和术后的数据进行比较。
发现志愿者与CECS患者的StO₂值存在显著差异。CECS患者的平均运动峰值StO₂值低于健康人（27对56，P<.05）。患者在基线与运动峰值StO₂之间的绝对变化和百分比变化更大（绝对值：60对35，P<.05；百分比：67对38，P<.05）。确诊为CECS的腿部的StO₂值在筋膜切开术后恢复到正常范围。所有变化与术前值相比均有显著差异。
StO₂可以区分健康腿部和患病腿部。本研究提供了证据，支持NIRS作为一种在诊断CECS时替代ICP的无创、无痛方法。
