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[机械阻抗:测量胫骨骨筋膜室综合征组织压力的一种新的非侵入性方法。I. 物理原理及动物实验结果]

[Mechanical impedance: a new, noninvasive method for measuring tissue pressure in tibial compartment syndrome. I. Physical principles and results of an animal experiment].

作者信息

Winckler S, Reder U, Ruland O, Lunkenheimer P P

机构信息

Klinik und Poliklinik für Unfall- und Handchirurgie, Westfälischen Wilhelms-Universität Münster.

出版信息

Unfallchirurg. 1991 Jan;94(1):22-7.

PMID:2028261
Abstract

The basic factor involved in the development of compartmental syndrome is increased tissue pressure, which leads to impairment of microcirculation, the ultimate cause of muscle cell necrosis, In practice, however, the technical side of pressure measurement has its problems since the current invasive methods using intracompartmental catheters are always at risk of infection. It would be preferable to do the assessment in a noninvasive way from the exterior the pressure that prevails inside. An apparatus was developed to measure the mechanical impedance in the soft tissue layer above the anterior tibial compartment: an impedance head is applied to the overlying tissue with a defined initial pressure. The impedance head contains a driving probe that touches the skin, a receptor measuring force, and acceleration. The ratio of force and acceleration describe and record the mechanical impedance [Z = kg/s]. The accuracy of the appliance was tested in a test using the hindlegs of 21 rabbits with compartmental syndrome, which was induced experimentally by gel instillation. The mechanical impedance was measured under increasing tissue pressures in the anterolateral muscle. We performed a total of 100 gel instillations and 121 times the mechanical impedance was measured at a frequency of 20 Hz. The graphs of all 21 measuring series showed an average rise of 0.0243 kg/s per cm H2O. In general, all graphs showed a linear rise in the mechanical impedance that was proportional to the intracompartmentally measured tissue pressures.

摘要

骨筋膜室综合征发展过程中的基本因素是组织压力升高,这会导致微循环受损,而微循环受损是肌肉细胞坏死的最终原因。然而在实际操作中,压力测量技术存在问题,因为目前使用骨筋膜室内导管的侵入性方法始终存在感染风险。最好能从外部以非侵入性方式评估骨筋膜室内的实际压力。为此研发了一种装置来测量胫骨前骨筋膜室上方软组织层的机械阻抗:将一个阻抗探头以确定的初始压力施加于覆盖其上的组织。该阻抗探头包含一个接触皮肤的驱动探针、一个测量力的感受器以及一个测量加速度的感受器。力与加速度的比值用于描述和记录机械阻抗[Z = kg/s]。在一项试验中,使用21只通过注入凝胶实验性诱导出骨筋膜室综合征的兔子的后肢,对该装置的准确性进行了测试。在增加前外侧肌肉组织压力的情况下测量机械阻抗。总共进行了100次凝胶注入,并以20 Hz的频率测量了121次机械阻抗。所有21个测量系列的图表显示,每厘米水柱下机械阻抗平均升高0.0243 kg/s。总体而言,所有图表均显示机械阻抗呈线性升高,且与骨筋膜室内测量的组织压力成正比。

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