Ojanen Raimo, Kaukinen Liisa, Seppälä Erkki, Kaukinen Seppo, Vapaatalo Heikki
Department of Anaesthesia and Intensive Care, Tampere University Hospital, Finland.
J Trauma. 2003 May;54(5):986-9. doi: 10.1097/01.TA.0000051589.20214.5A.
Ischemia, such as that caused by a tourniquet, stimulates thromboxane (Tx) A(2) synthesis. TxA(2) might sensitize the operated limb to various complications, such as compartment syndrome and thromboembolic events.
We studied the effect of pretreatment with a single dose of acetylsalicylic acid (ASA) (25, 100, and 500 mg) given 3 hours before surgery on the formation of TxB(2), a stable metabolite of TxA(2), after tourniquet deflation in 32 knee or ankle surgery patients.
Tourniquet time varied between 60 +/- 8 to 71 +/- 7 (SE) minutes. In control patients without ASA pretreatment, the platelet-produced femoral vein serum TxB(2) concentration over 30 minutes in vitro coagulation increased remarkably (from 40.0 +/- 20 ng/mL to 73.5 +/- 39 ng/mL) immediately after tourniquet deflation. Plasma concentrations increased similarly, approximately threefold. Pretreatment with 100 or 500 mg ASA prevented the increase in TxB(2) concentrations. Radial artery concentrations of TxB(2) were similar to venous concentrations in the different treatment groups.
Pretreatment with a single 100-mg dose of ASA prevents the release of TxB(2) after tourniquet deflation.
缺血，如由止血带引起的缺血，会刺激血栓素（Tx）A₂的合成。TxA₂可能会使手术肢体对各种并发症敏感，如骨筋膜室综合征和血栓栓塞事件。
我们研究了在32例膝关节或踝关节手术患者中，术前3小时给予单剂量阿司匹林（ASA）（25、100和500毫克）预处理对止血带放气后TxA₂的稳定代谢产物TxB₂形成的影响。
止血带使用时间在60±8至71±7（标准误）分钟之间。在未进行ASA预处理的对照患者中，止血带放气后立即在体外凝血30分钟内，血小板产生的股静脉血清TxB₂浓度显著增加（从40.0±20纳克/毫升增至73.5±39纳克/毫升）。血浆浓度也有类似增加，约为三倍。100或500毫克ASA预处理可防止TxB₂浓度升高。不同治疗组桡动脉TxB₂浓度与静脉浓度相似。
术前单次给予100毫克ASA预处理可防止止血带放气后TxB₂的释放。
