Thorsson O, Lilja B, Nilsson P, Westlin N
Department of Clinical Physiology, Malmö University Hospital, Lund University, Sweden.
Scand J Med Sci Sports. 1997 Jun;7(3):182-90. doi: 10.1111/j.1600-0838.1997.tb00137.x.
In a prospective, non-randomized study 40 athletes with contusion or distension injuries to the thigh or the calf muscle were followed with tests of range of motion (ROM) of knee or ankle joint, test of serum creatine kinase (CK) and ultrasonography of the injury until completely recovered. An experimental group of 19 injuries where subjects received treatment with application of a maximum compression bandage within 5 min (mean = 2 min) of the injury was compared to a control group of 21 injuries where subjects were treated with rest and elevation only, and in some cases non-maximum compression after 10-30 min. No significant differences were noted with respect to time to complete subjective recovery, ultrasonic size of the injury or time to normal findings on ultrasound between treatment and control groups. Strain injuries, although showing a tendency to be smaller in size, took a longer time to complete recovery than contusion injuries (mean +/- SD = 26 +/- 22 days and 19 +/- 9 days, respectively, P = 0.02). Diagnostic CK values and reductions in ROM were not correlated to the severity of the trauma, while ROM showed weak correlation to the sonographically measured size of the hematoma (r = 0.42: P < 0.01). Injuries displaying a circumscript anechoic, low-echogenic or mixed lesion at the diagnostic ultrasound investigation normalized more slowly (P = 0.001) and took longer to complete recovery (P = 0.001) than injuries with diffuse hyperechogenic lesions. We conclude that in this study the application of a maximum compression bandage within 5 min of a muscle trauma did not significantly reduce the size of the hematoma nor significantly shorten the time to complete subjective recovery compared with no immediate treatment. The diagnostic ultrasound investigation was valuable in predicting the severity of the trauma.
在一项前瞻性、非随机研究中，对40名大腿或小腿肌肉有挫伤或拉伤的运动员进行随访，直至完全康复，期间进行膝关节或踝关节活动范围（ROM）测试、血清肌酸激酶（CK）测试以及损伤部位的超声检查。将19例损伤的实验组与21例损伤的对照组进行比较，实验组在损伤后5分钟内（平均2分钟）接受最大压力绷带治疗，对照组仅接受休息和抬高治疗，部分病例在10 - 30分钟后接受非最大压力治疗。治疗组和对照组在完全主观恢复时间、损伤的超声大小或超声检查恢复正常的时间方面均未发现显著差异。拉伤损伤虽然尺寸有变小的趋势，但比挫伤损伤需要更长时间才能完全恢复（分别为平均±标准差 = 26±22天和19±9天，P = 0.02）。诊断性CK值和ROM的降低与创伤严重程度无关，而ROM与超声测量的血肿大小呈弱相关（r = 0.42，P < 0.01）。在诊断性超声检查中显示为局限性无回声、低回声或混合性病变的损伤，与弥漫性高回声病变的损伤相比，恢复更慢（P = 0.001），且完全恢复所需时间更长（P = 0.001）。我们得出结论，在本研究中，与不立即治疗相比，在肌肉创伤后5分钟内应用最大压力绷带并不能显著减小血肿大小，也不能显著缩短完全主观恢复的时间。诊断性超声检查在预测创伤严重程度方面具有重要价值。
