阿基里氏肌腱微循環之測量與物理治療臨床運用

Achilles Tendon Mmicrocirculation and Clinical Application

張逸平(Yi-Ping Chang) ； 尹乃鎬(Nai-Hao Yin) ； 王興國(Hsing-Kuo Wang)

《物理治療》 39卷2期 (2014/06) Pp. 65-73

https://doi.org/10.6215/JFPT.PTS1384223712

摘要

肌腱內缺血或缺氧可能造成肌腱內細胞死亡或修補受阻，導致慢性肌腱病變發生，因此對於肌腱內供血狀況的了解有助於相關疾病之預防與治療。肌腱微循環範圍包含肌腱內小動脈、微血管與小靜脈血管分佈或血液供應，代表肌腱細胞外環境含氧與肌腱細胞耗氧之淨效應。測量微循環常用的非侵入式方法有近場遠紅外線光譜（near-infrared spectroscopy, NIRS）或紅光雷射（red laser），所測量的參數主要有血量與組織氧飽和度，血量以總血紅蛋白表示。根據過去研究，健康人與中段阿基里氏肌腱出現退化之肌腱病變患者的肌腱微循環表現並不同，後者之局部血流及血管新生現象較為顯著，並和疼痛等臨床指標有關。量測肌腱微循環可為物理治療專業在針對肌腱病變的危險因子識別、治療療效比較以及治療效果提供實證，然而應重視現有量測方法所存在之限制，以得到可信的結果。

關鍵字

微循環 ； 物理治療 ； 肌腱病變

並列摘要

Intratendinous ischemia or hypoxia may cause the death of intratendinous cells or the prevention of repair, leading to the development of tendinosis. Thus, knowing the situation of intratendinous blood supply is helpful to prevent and treat related diseases. Tendon microcirculation involves the vessel distribution and blood supply in the arteriolar, capillary, and venular segments. The frequently used noninvasive measuring techniques include near-infrared spectroscopy and red laser light. Main parameters include blood volume and tissue oxygen saturation (StO_2); the former is represented by total hemoglobin (THb). According to previous studies, tendon microcirculation is different between the healthy subjects and the patients with mid-portion Achilles tendinopathy. There're significantly increased local blood flow and angiogenesis in the degenerated tendon, which were associated with the clinical outcome such as pain. Measuring tendon microcirculation can provide evidence of the identification of tendinopathy risk factor as well as the comparison of different treatment effect for the physical therapy specialties. However, one should still be aware of the limitations of current measuring techniques to get reliable results.

並列關鍵字

Microcirculation ； Physical therapy ； Tendinopathy