CAJ | 학술논문

背景：间室综合征（CS)临床上偶有发生，根据症状体征结合间室内压（ICP）测定进行判断更安全，对于缺乏ICP测定设备的情况下，症状体征不失为简单且重要的判断方法，但难以量化。 　　目的：分析ICP与症状体征评分在CS早期诊断中的相关性。 　　方法：对符合纳入标准的80例患者进行症状体征评分的同时进行ICP测量，先由专科医师记录症状体征并按评分标准进行评分，记录总分值作为评分组；再采用CYY-1型自动筋膜压测量仪对前臂与小腿肿胀进行ICP测量，计算ΔP（舒张压-ICP）作为测压组。测压组与评分组采用自身对照。采用单因素线性回归分析，判断症状体征评分与ΔP的相关系数是否存在线性相关；采用配对卡方检验，分析通过症状体征评分和ΔP判断发生CS的数量是否存在统计学差异。结果：80例患者符合纳入标准，并进行为期1周的临床观察，其中6例的症状体征评分＞10分且ΔP＜4 kPa，一致判断为CS，并予以切开减压处理，症状体征评分与ΔP存在线性关系（r=0.822）；症状体征评分和ΔP判断发生CS的数量分别为6例和14例，相比较有统计学差异（P=0.008），说明两种判断方法对CS的诊断存在一定区别，以ΔP判断可以发现更多存在潜在危险的患者。 　　结论：采用症状体征评分进行CS判定存在一定风险性；采用ΔP＜4 kPa作为切开减压标准极少出现CS未检出的情况。因此，以ΔP＜4 kPa作为切开减压标准的同时仍需要结合症状体征进行综合考虑。
배경：간실종합정（CS)림상상우유발생，근거증상체정결합간실내압（ICP）측정진행판단경안전，대우결핍ICP측정설비적정황하，증상체정불실위간단차중요적판단방법，단난이양화。 　　목적：분석ICP여증상체정평분재CS조기진단중적상관성。 　　방법：대부합납입표준적80례환자진행증상체정평분적동시진행ICP측량，선유전과의사기록증상체정병안평분표준진행평분，기록총분치작위평분조；재채용CYY-1형자동근막압측량의대전비여소퇴종창진행ICP측량，계산ΔP（서장압-ICP）작위측압조。측압조여평분조채용자신대조。채용단인소선성회귀분석，판단증상체정평분여ΔP적상관계수시부존재선성상관；채용배대잡방검험，분석통과증상체정평분화ΔP판단발생CS적수량시부존재통계학차이。결과：80례환자부합납입표준，병진행위기1주적림상관찰，기중6례적증상체정평분＞10분차ΔP＜4 kPa，일치판단위CS，병여이절개감압처리，증상체정평분여ΔP존재선성관계（r=0.822）；증상체정평분화ΔP판단발생CS적수량분별위6례화14례，상비교유통계학차이（P=0.008），설명량충판단방법대CS적진단존재일정구별，이ΔP판단가이발현경다존재잠재위험적환자。 　　결론：채용증상체정평분진행CS판정존재일정풍험성；채용ΔP＜4 kPa작위절개감압표준겁소출현CS미검출적정황。인차，이ΔP＜4 kPa작위절개감압표준적동시잉수요결합증상체정진행종합고필。
Background:Compartment syndrome (CS) occurs occasionally in clinics. It is safer to diagnose it according to symptoms and signs with the combination of intra-compartmental pressure (ICP) determination. But if there is a lack of ICP measurement equipment, judging by signs and symptoms may be a simple and important method, but it is difficult to quantify. Objective:To analyze the correlation of ICP and symptom sign scores in early diagnosis of CS. Methods:Symptoms and ICP of 80 patients who satisfied the inclusion criteria were estimated and measured. First, specialists recorded their clinical symptoms and gave them scores according to the scoring standards, and summed their total scores as scoring group;then, they measured the ICP of forearms and lower legs with CYY-1 auto fascia pressure measuring instru-ment, and calculated theΔP (ΔP=diastolic blood pressure-ICP) as measuring compression group. The two groups were evalu-ated with self-control method. The single factor linear regression analysis was adopted in judging whether there was a linear correlation between symptom sign scores and correlation coefficient ofΔP;and the paired chi-square test was applied in ana-lyzing whether there was statistical difference in the quantities of CS occurrence judged by symptom sign scores andΔP. Results:The 80 patients who met the inclusion criteria received a one-week clinical observation. Six of them whose symp-tom sign scores >10 points and ΔP<4 kPa were all diagnosed with CS, and were treated with incision decompression. There was a linear relationship between the scoring value andΔP (r=0.822). However, quantities of CS occurance judged by symptom sign scores andΔP were 6 cases and 14cases respectively. There was statistical difference between the two meth-ods. Therefore, there was a certain difference between them, and more potential cases can be found with the judgment ofΔP. Conclusions:It is dangerous to judge CS only by symptom sign scores;IfΔP<4 kPa is selected as the standard of incision decompression, CS can seldom not be detected. Therefore, it is necessary to takeΔP<4 kPa as the standard of incision de-compression and take signs and symptoms into comprehensive consideration at the same time.