Shuler Michael S, Reisman William M, Whitesides Thomas E, Kinsey Tracy L, Hammerberg E Mark, Davila Maria G, Moore Thomas J
Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.
J Bone Joint Surg Am. 2009 Jun;91(6):1360-8. doi: 10.2106/JBJS.H.00347.
Near-infrared spectroscopy measures the percentage of hemoglobin oxygen saturation in the microcirculation of tissue up to 3 cm below the skin. The purpose of this study was to describe the measurable response of normal tissue oxygenation in the leg after acute trauma with use of this technique.
Twenty-six patients with acute unilateral tibial fractures and twenty-five uninjured volunteer control subjects were enrolled. Near-infrared spectroscopy measurements were obtained for both legs in all four compartments: anterior, lateral, deep posterior, and superficial posterior. The twenty-six injured legs were compared with twenty-five uninjured legs (randomly selected) of the volunteer control group, with the contralateral limb in each patient serving as an internal control.
The mean tissue oxygenation for each compartment in the injured legs was 69% (anterior), 70% (lateral), 74% (deep posterior), and 70% (superficial posterior). In the control (uninjured) legs, the average tissue oxygenation percentage in each compartment was 54%, 55%, 60%, and 57%, respectively. Repeated-measures analysis revealed that near-infrared spectroscopy values averaged 15.4 percentage points (95% confidence interval, 12.2 to 18.6 percentage points) higher for injured legs than for uninjured legs, controlling for the value of the contralateral limb (p < 0.0001).
Tibial fracture produces a predictable increase in tissue oxygenation as measured by near-infrared spectroscopy. The corresponding compartment of the contralateral leg can provide strong utility as an internal control value when evaluating the hyperemic response to injury.
近红外光谱法可测量皮肤以下3厘米深度组织微循环中的血红蛋白氧饱和度百分比。本研究的目的是描述使用该技术时急性创伤后腿部正常组织氧合的可测量反应。
纳入26例急性单侧胫骨骨折患者和25名未受伤的志愿者对照者。对所有四个腔室的双腿进行近红外光谱测量：前侧、外侧、深后侧和浅后侧。将26条受伤腿与志愿者对照组中随机选择的25条未受伤腿进行比较，每位患者的对侧肢体作为内部对照。
受伤腿各腔室的平均组织氧合分别为69%（前侧）、70%（外侧）、74%（深后侧）和70%（浅后侧）。在对照（未受伤）腿中，每个腔室的平均组织氧合百分比分别为54%、55%、60%和57%。重复测量分析显示，在控制对侧肢体值的情况下，受伤腿的近红外光谱值比未受伤腿平均高15.4个百分点（95%置信区间，12.2至18.6个百分点）（p < 0.0001）。
胫骨骨折会使近红外光谱测量的组织氧合产生可预测的增加。在评估损伤后的充血反应时，对侧腿的相应腔室可作为内部对照值发挥重要作用。
