止血带对膝部骨内压的影响及其临床意义

EFFECT OF TOURNIQUET STRESS TEST ON INTRAOSSEOUS PRESSURE OF THE KNEE REGION AND ITS CLINICAL SIGNIFICANCE

作者对５０例膝痛患者进行了双侧膝关节Ｘ线检查，膝部骨内压测定以及止血带加压试验。休息痛膝的髌骨、股骨远端和胫骨近端骨内压平均值分别为４．５１ｋＰａ、４．１５ｋＰａ和３．５４ｋＰａ，无痛膝（对照组）三个部位骨内压平均值分别为２．７５ｋＰａ、３．０７ｋＰａ和２．８４ｋＰａ。休息痛膝的髌骨、股骨远端及胫骨近端骨内压均明显高于无痛膝（Ｐ＜０．０２）。止血带加压试验休息痛膝阳性率为９２．７３％，活动痛膝阳性率为２１．４３％，无痛膝均为阴性。结果表明骨内压增高、休息痛和止血带加压试验阳性三者呈一致性关系，本文提出了膝部骨内高压症，认为止血带加压试验可作为诊断该症的一个体征。

Fifty patients with chronic pain in the knee were investigated by means ofbilateral radiography,tourniquet stress test(a new physical test)and intraosseous pressure(IOP)measurements. In the knee with rest pain,the mean IOP in the patella,the distal endof the femur and the proximal end of the tibia is 4. 51,4.51 and 3.54 kPa respectively. Theyare significantly higher than that in the knee without pain(control knee)(P<0.02).TheIOP difference between the knee with pain during activity and the knee without pain is of nostatistic significance(P>0. 05).The tourniquet stress test showed that 92.73%of the kneesuffering rest pain had a positive response compared with 21. 43%of the activity pain joints,for the control knee,the test is all negative. Our study demonstrated that there is a closecorrelation among rest pain,increased IOP and positive tourniquet stress test.The chronicpain of the knee with these characteristics might be called″Intraosseous Hypertension of theKnee″The tourniquet stress test can be used as a screening method in the diagnosis of thisdisorder.