Intramuscular deoxygenation during exercise in patients who have chronic anterior compartment syndrome of the leg
Intramuscular deoxygenation during exercise in patients who have chronic anterior compartment syndrome of the leg
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DOI：
10.2106/00004623-199706000-00007
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发表时间：
1997-06-01
影响因子：
5.3
通讯作者：
Gershuni, DH
中科院分区：
文献类型：
--
作者：
Randall, L;Styf, JR;Gershuni, DH
目前，慢性骨筋膜室综合征的明确诊断是基于骨筋膜室内压力的侵入性测量。我们测量了 18 名怀疑患有慢性骨筋膜室综合征的患者以及 10 名对照受试者在运动前、运动中和运动后的肌内压和腿部前室的相对氧合情况。如果运动前肌内压至少为 15 毫米汞柱（2.00 千帕），运动后一分钟至少为 30 毫米汞柱（4.00 千帕），或至少为 20 毫米，则认为存在慢性筋膜室综合征。运动后五分钟汞（2.67 千帕）。采用近红外光谱无创方法测量相对氧合变化。所有患者和受试者在开始运动后均出现快速相对脱氧，持续运动期间氧合水平保持相对稳定，停止运动后复氧水平超过运动前静息水平。慢性筋膜室综合征患者在运动过程中出现最大相对脱氧（平均相对脱氧[和标准误]， -290 +/- 39 毫伏）显着高于没有慢性筋膜室综合征的患者（-190 +/- 10 毫伏）和对照受试者（-179 +/- 14 毫伏）（两种比较的 p < 0.05）。此外，患有慢性骨筋膜室综合征的患者（184+/-54秒）从停止运动到恢复运动前静息氧合水平之间的间隔明显长于没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）（两种比较p<0.05）。 临床相关性：患有慢性前骨筋膜室综合征的患者腿部在运动过程中相对脱氧较多，运动后复氧延迟；这些发现支持慢性骨筋膜室综合征的缺血性病因。近红外光谱可用作非侵入性诊断工具，用于评估怀疑患有慢性腿部前室综合征的患者。
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),CLINICAL RELEVANCE: Patients who had chronic anterior compartment syndrome of the leg had greater relative deoxygenation during exercise as well as delayed reoxygenation after exercise; these findings support an ischemic etiology for chronic compartment syndrome. Near-infrared spectroscopy may be useful as a non-invasive diagnostic tool for the evaluation of patients suspected of having chronic anterior compartment syndrome of the leg.