白跃宏，欧阳颀，杨远滨，张龙海.慢性骨筋膜室综合征所致慢性腰痛的临床诊断、治疗与康复[J].中华物理医学与康复杂志,2003,(9):.-
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| 慢性骨筋膜室综合征所致慢性腰痛的临床诊断、治疗与康复 |
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| DOI： |
| 中文关键词: 腰骶部慢性骨筋膜室综合征 慢性腰痛 临床诊断 治疗 康复 |
| 英文关键词: Chronic compartment syndrome Chronic lumbar pain Clinical diagnosis Treatment Rehabilitation |
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| 中文摘要: |
| 目的探讨由腰骶部慢性骨筋膜室综合征所致慢性腰痛的临床诊断、手术治疗和康复方法。 方法对慢性腰痛患者采用临床检查、腰骶部竖脊肌骨筋膜室内压测量方法诊断为慢性骨筋膜室综合征者39例，其中男17例，女22例；年龄18~66岁，平均40.6岁；慢性腰痛时间2~42年，平均25.5年。采用微创方法行腰骶部竖脊肌骨筋膜室切开减压术，术后2d开始进行腰、腹肌功能训练。 结果治疗后腰痛临床症状较术前明显好转、步行能力明显增加，腰部前屈、后伸活动度较术前分别增加(15±0.5)°和(7±0.7)°，腰骶部骨筋膜室内压在静息、运动中和运动后6 min以内，统计结果分别为(6.6±0.7)，(160.3±11.15)和(6.9±0.8)mmHg［术前分别为(11.1±0.7)，(188.1±12.08)和(14.1±1.2)mmHg］，两组相比较差异均有统计学意义(P<0.05)。超声多普勒表明腰骶部骨骼肌内最大血流速度和平均血流速度较术前分别增加(0.17±0.02)和(0.09±0.01)kHz。 结论应用临床检查及骨筋膜室内压测定的方法诊断由腰骶部慢性骨筋膜室综合征所致慢性腰痛是可靠的。治疗上可采用骨筋膜室切开减压术。术后腰、腹肌康复训练是必要的。 |
| 英文摘要: |
| Objective To study the methods of clinical diagnosis and treatment of chronic lumbar pain induced by chronic compartment syndrome. MethodsThirty-nine patients with chronic lumbar pain induced by chronic compartment syndrome were recruited. Their diagnosis was confirmed by physical examination and measurement of of lumbar muscle intra-compartment pressure. Micro-invasive opening decompression of the lumbar compartment was performed for treating these patients. Therapeutic exercises of the lumbar and abdomen muscles were administered 2-days after operation. ResultsAfter treatment, the symptoms were significantly relieved, distance of walk in creased as compared with those before operation. The ranges of trunk flexion and extension were increased. A comparison with the pretreatment showed that the lumbar muscle intra-compartment pressures at rest during movement and 6 min after movement were decreased(6.6±0.7 vs 11.1±0.7),(160.3±11.15 vs 188.1±12.08)and(6.9±0.8 vs 14.1±1.2)mmHg, respectively (P<005).Results of ultrasonic Doppler on lumbar muscle showed that the maximum and mean blood flow velocities were increased by (0.17±0.02)kHz and (0.09±0.01)kHz, respectively, compared to those before operation. ConclusionDiagnosis of chronic lumbar pain induced by chronic compartment syndrome using methods of clinical physical examination and determination of lumbar muscle intracompartment pressure is reliable. The opening decompression of the lumbar compartment in combination with trunk muscle exercise is effective for management of this disease. |
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