Mohler L R, Styf J R, Pedowitz R A, Hargens A R, Gershuni D H
University of California at San Diego, 92103-8894, USA.
J Bone Joint Surg Am. 1997 Jun;79(6):844-9. doi: 10.2106/00004623-199706000-00007.
Currently, the definitive diagnosis of chronic compartment syndrome is based on invasive measurements of intracompartmental pressure. We measured the intramuscular pressure and the relative oxygenation in the anterior compartment of the leg in eighteen patients who were suspected of having chronic compartment syndrome as well as in ten control subjects before, during, and after exercise. Chronic compartment syndrome was considered to be present if the intramuscular pressure was at least fifteen millimeters of mercury (2.00 kilopascals) before exercise, at least thirty millimeters of mercury (4.00 kilopascals) one minute after exercise, or at least twenty millimeters of mercury (2.67 kilopascals) five minutes after exercise. Changes in relative oxygenation were measured with use of the non-invasive method of near-infrared spectroscopy. In all patients and subjects, there was rapid relative deoxygenation after the initiation of exercise, the level of oxygenation remained relatively stable during continued exercise, and there was reoxygenation to a level that exceeded the pre-exercise resting level after the cessation of exercise. During exercise, maximum relative deoxygenation in the patients who had chronic compartment syndrome (mean relative deoxygenation [and standard error], -290 +/- 39 millivolts) was significantly greater than that in the patients who did not have chronic compartment syndrome (-190 +/- 10 millivolts) and that in the control subjects (-179 +/- 14 millivolts) (p < 0.05 for both comparisons). In addition, the interval between the cessation of exercise and the recovery of the pre-exercise resting level of oxygenation was significantly longer for the patients who had chronic compartment syndrome (184 +/- 54 seconds) than for the patients who did not have chronic compartment syndrome (39 +/- 19 seconds) and the control subjects (33 +/- 10 seconds) (p < 0.05 for both comparisons).
目前，慢性骨筋膜室综合征的确诊基于骨筋膜室内压力的有创测量。我们在18例疑似慢性骨筋膜室综合征的患者以及10名对照受试者运动前、运动期间和运动后，测量了小腿前侧骨筋膜室内的肌肉压力和相对氧合情况。如果运动前肌肉压力至少为15毫米汞柱（2.00千帕斯卡）、运动后1分钟至少为30毫米汞柱（4.00千帕斯卡）或运动后5分钟至少为20毫米汞柱（2.67千帕斯卡），则认为存在慢性骨筋膜室综合征。使用近红外光谱的非侵入性方法测量相对氧合的变化。在所有患者和受试者中，运动开始后相对氧合迅速下降，在持续运动期间氧合水平保持相对稳定，运动停止后氧合恢复到超过运动前静息水平。运动期间，患有慢性骨筋膜室综合征的患者的最大相对脱氧（平均相对脱氧[及标准误差]，-290±39毫伏）显著大于未患有慢性骨筋膜室综合征的患者（-190±10毫伏）和对照受试者（-179±14毫伏）（两项比较均P<0.05）。此外，患有慢性骨筋膜室综合征的患者运动停止至氧合恢复到运动前静息水平的间隔时间（184±54秒）显著长于未患有慢性骨筋膜室综合征的患者（39±19秒）和对照受试者（33±10秒）（两项比较均P<0.05）。
