PATHOPHYSIOLOGY OF THE COMPARTMENT SYNDROME

本项目的总体目标是研究青光眼的病理生理学。 与肌内压升高相关的急性筋膜间室综合征 肌肉和神经的短期和长期测试的变量 功能。肌内压力由灯芯持续监测 技术。短期测试将应用于急性胰腺炎的人体模型 隔室综合征，而长期测试将在加压后进行 犬自体血浆前外侧隔室。 狗的研究将确定长期、不可逆的肌神经性疾病的阈值 肌内注射不同幅度和持续时间后的功能障碍 压力。肌肉功能测试将包括等长抽动扭矩， 拍打张力的时间，一半松弛时间，等长强直扭矩， 和耐力。功能变化将与肌肉相关 光镜下观察神经形态。 受试者对前室的外压缩将 评价腓神经功能障碍的压力-时间阈值 肌肉内压。此模型的结果将与 动脉血压，并将被用来客观地确定最佳 神经学技术用于评估在急性， 前室综合征。在另一项单独的研究中，足部和 膝关节位置对肌肉内压的影响将在患者中确定 有胫骨骨折。最后，高压氧将用于治疗 腰腿痛和减压后急性筋膜间室综合征患者。 先前对狗的研究证明肌肉坏死显著减少。 高压氧治疗引起的水肿症。我们的长期目标是 提高对急性筋膜间隔综合征的诊断和治疗水平 血压正常、高血压和低血压的患者(例如 震惊)。

The overall objective of this project is to study the pathophysiology of acute compartment syndromes by correlating elevated intramuscular pressure variables with short-term and long-term tests of muscle and nerve function. Intramuscular pressure is continuously monitored by the wick technique. Short-term tests will be applied to a human model of acute compartment syndrome, whereas long-term tests will follow pressurization of the canine anterolateral compartment by autologous plasma. Dog studies will determine thresholds of long-term, irreversible myoneural dysfunction after varying amplitudes and durations of intramuscular pressure. Tests of muscle function will include isometric twitch torque, time to peck tension, one-half relaxation time, isometric tetanic torque, and endurance capacity. Functional changes will be correlated with muscle and nerve morphology using light microscopy. External compression of the anterior compartment in human subjects will assess pressure-time thresholds of peroneal nerve dysfunction with elevated intramuscular pressure. Results with this model will be correlated with arterial blood pressures and will be used to determine objectively the best neurological technique for evaluating foot sensibility during an acute, anterior compartment syndrome. In a separate study, the effect of foot and knee position on intramuscular pressures will be determined in patients with tibial fracture. Finally, hyperbaric oxygen will be used to treat impendin and postdecompression acute compartment syndromes in patients. Previous studies of dogs document significant reductions of muscle necrosis and edema with hyperbaric oxygen treatment. Our long-term objective is to improve the diagnosis and management of acute compartment syndromes in patients with normal blood pressures, hypertension, and hypotension (e.g. shock).