Gutin B, Warren R, Wickiewicz T, O'Brien S, Altchek D, Kroll M
Department of Sports Medicine, Hospital for Special Surgery, New York, N.Y 10021.
Arthroscopy. 1991;7(1):52-6. doi: 10.1016/0749-8063(91)90078-c.
This article explores the issue of whether use of a tourniquet during arthroscopically assisted repair of the anterior cruciate ligament (ACL) slows the postoperative recovery of function. A tourniquet is customarily used to provide a bloodless field, thus enabling the surgeon to visualize the joint clearly. However, there is increasing evidence that tourniquets cause muscle and nerve damage that can have long-term consequences for the recovery of function following surgery. The two randomized trials that investigated tourniquet use during meniscectomy reached contradictory conclusions about the effects of the tourniquet. There have been no randomized trials of tourniquet use during the longer and more complex ACL surgery. This article reviews the pertinent literature and suggests some clinical implications of the available information.
本文探讨了在关节镜辅助下前交叉韧带(ACL)修复术中使用止血带是否会延缓术后功能恢复这一问题。通常使用止血带是为了提供无血视野,从而使外科医生能够清晰地观察关节。然而,越来越多的证据表明,止血带会导致肌肉和神经损伤,这可能会对术后功能恢复产生长期影响。两项关于半月板切除术中使用止血带的随机试验,对于止血带的影响得出了相互矛盾的结论。在更长且更复杂的ACL手术中,尚未有关于使用止血带的随机试验。本文回顾了相关文献,并提出了现有信息的一些临床意义。