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创伤性肌肉损伤。

Traumatic muscle injury.

机构信息

Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France.

Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.

出版信息

Nat Rev Dis Primers. 2023 Oct 19;9(1):56. doi: 10.1038/s41572-023-00469-8.

Abstract

Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.

摘要

创伤性肌肉损伤是一组由肌肉组织创伤引起的骨骼肌肉病理,定义为肌肉组织的损伤,可导致功能缺陷。创伤性肌肉损伤可影响各个年龄段的人群,可由骨骼肌肉组织的高应力和应变引起,通常是由于肌肉在伸展时的激活,导致间接和非接触性肌肉损伤(拉伤或撕裂),或由外部冲击引起,导致直接肌肉损伤(挫伤或裂伤)。在微观水平上,肌肉纤维可以修复局灶性损伤,但必须在完全肌纤维坏死后完全再生。肌肉损伤的诊断基于患者的病史和体格检查。影像学检查可能有助于排除鉴别诊断。在过去的 5 年中,肌肉损伤的管理已经从最初的休息、固定和(过度)保护转变为早期激活和使用主动方法进行渐进性加载。肌肉损伤管理的一个挑战是,尽管疗效证据非常有限,但经常使用或提出许多医疗治疗选择,如药物和注射,以试图加速肌肉恢复。另一个挑战是由于这种损伤的多因素和复杂性,预防肌肉损伤。

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