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腘动脉受压综合征的临床表现、诊断与治疗:61条腿11年的经验

Presentation, diagnosis, and management of popliteal artery entrapment syndrome: 11 years of experience with 61 legs.

作者信息

Corneloup L, Labanère C, Chevalier L, Jaussaud J, Mignot A, Gencel L, Corneloup O, Midy D

机构信息

Unité de cardiologie du sport, Clinique du Sport de Bordeaux-Mérignac, Mérignac, France.

Unité de médecine du sport, Clinique du Sport de Bordeaux-Mérignac, Mérignac, France.

出版信息

Scand J Med Sci Sports. 2018 Feb;28(2):517-523. doi: 10.1111/sms.12918. Epub 2017 Jun 13.

Abstract

Popliteal artery entrapment syndrome (PAES) is still underdiagnosed yet it may significantly interfere with lifestyle, especially among young sportspeople, with symptoms like intermittent claudication. Although case reports and small case series are sometimes published, studies with larger populations are quite rare. This study summarizes our experience with PAES on 61 limbs (35 patients) over a period of 11 years, describing the demographics, the disease, and the diagnostic and therapeutic methods used with PAES patients. In a population of 327 consecutive explored symptomatic sportspersons, PAES was confirmed in 35 patients on 61 pathologic limbs. The median time with the symptoms before diagnosis was 34 months (range, 3-180 months). The mean age of patients was 30.5 years (range, 17-52 years) with 83% of males. The proportion of patients diagnosed with bilateral PAES was 74%. The main sports practiced were running (15 patients, 43%), soccer (nine patients, 26%), rugby (two patients), and athletics (two patients). Among 21 patients, intra-compartmental pressure measurements (ICP) found 18 (86%) to have an associated chronic exertional compartment syndrome (CECS). Among the patients followed up after PAES surgery, 80% were able to resume sport at a level comparable to that before the onset of pain. PAES could be sought earlier in young sportspeople who experience unexplained leg pain during exercise to diagnose the disease and avoid complications in a timely manner. Compartmental pressures should systematically be measured in the search for an associated CECS.

摘要

腘动脉压迫综合征(PAES)仍未得到充分诊断,但它可能会严重影响生活方式,尤其是在年轻运动员中,会出现间歇性跛行等症状。尽管有时会发表病例报告和小病例系列,但针对较大人群的研究却相当罕见。本研究总结了我们在11年期间对61条肢体(35例患者)的PAES治疗经验,描述了患者的人口统计学特征、疾病情况以及用于PAES患者的诊断和治疗方法。在连续接受检查的327例有症状的运动员中,35例患者的61条病变肢体被确诊为PAES。诊断前出现症状的中位时间为34个月(范围为3 - 180个月)。患者的平均年龄为30.5岁(范围为17 - 52岁),其中男性占83%。被诊断为双侧PAES的患者比例为74%。主要从事的运动项目有跑步(15例患者,43%)、足球(9例患者,26%)、橄榄球(2例患者)和田径(2例患者)。在21例患者中,通过测量肌室内压力(ICP)发现18例(86%)伴有慢性运动性肌间隔综合征(CECS)。在PAES手术后接受随访的患者中,80%能够恢复到与疼痛发作前相当的运动水平。对于在运动中出现不明原因腿痛的年轻运动员,应尽早排查PAES,以便及时诊断疾病并避免并发症。在排查是否伴有CECS时,应系统地测量肌室内压力。

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