Saffle J R, Zeluff G R, Warden G D
Am J Surg. 1980 Dec;140(6):825-31. doi: 10.1016/0002-9610(80)90126-9.
Using a wick catheter technique, sequential measurements of intramuscular pressure were obtained in 31 burned arms in 18 patients. Abnormally high pressures were recorded in 90 percent of extremities and exceeded the potentially harmful level of 30 mm Hg in 42 percent. Correlation of intramuscular pressure with signs and symptoms of extremity compression, including Doppler pulses, was poor. Intramuscular pressure elevation appeared to parallel edema formation beneath the burn wound. A high incidence of pressure measurements in excess of 30 mm Hg was found in patients who had 30 percent or greater total body surface area injury (67 percent), 10 percent or greater full-thickness burns (75 percent), and extremities with circumferential involvement (57 percent). In every case echarotomy produced a dramatic decrease in intramuscular pressure, while a randomized group of extremities that were not decompressed developed sustained pressures as high as 64 mm Hg despite the presence of intact Doppler pulses. Extremities treated in this manner appeared slower in resolving edema and regaining motion and strength. Measurement of intramuscular pressure beneath the burn eschar is recommended in evaluating all patients at risk from extremity burns.
采用 Wick 导管技术，对 18 例患者的 31 条烧伤上肢进行了肌肉内压力的连续测量。90%的肢体记录到异常高压，42%超过了 30 mmHg 这一潜在有害水平。肌肉内压力与肢体受压的体征和症状（包括多普勒脉搏）之间的相关性较差。肌肉内压力升高似乎与烧伤创面下的水肿形成平行。在全身表面积损伤达 30%或更高（67%）、全层烧伤达 10%或更高（75%）以及肢体有环形受累（57%）的患者中，发现肌肉内压力测量值超过 30 mmHg 的发生率很高。在每种情况下，焦痂切开术都使肌肉内压力显著降低，而一组未减压的随机分组肢体尽管多普勒脉搏正常，但仍出现高达 64 mmHg 的持续压力。以这种方式治疗的肢体在消退水肿以及恢复运动和力量方面似乎较慢。建议对所有有肢体烧伤风险的患者进行烧伤焦痂下肌肉内压力的测量。
