Klein H O, Brodsky E, Ninio R, Bakst A, Di Segni E, Oren V, Beker B, Kaplinsky E
Harefuah. 1989 Jan 1;116(1):32-4.
Rotating tourniquets are traditionally part of the treatment of acute pulmonary edema. However, their effectiveness has been questioned. A radioisotope technique was therefore used to evaluate directly the increments in the blood volume of the leg after venous occlusion using a pressure of 60 mmHg in 26 patients with left ventricular (LV) dysfunction following myocardial infarction. The increment in mean radionuclide count at serial 15-second intervals (reflecting the blood volume in the leg distal to the occlusion) increased significantly from the pre-occlusion value by 46 +/- 26% (p less than 0.0005). Thus satisfactory trapping of blood is achieved even in LV failure. However, mean ejection fraction decreased slightly but significantly from 0.23 +/- 0.10 to 0.21 +/- 0.10 (p less than 0.05), a decrease observed in 18 of the 26 patients. LV end-diastolic and end-systolic volume equivalents tended to decrease slightly, but not in all patients. Mean stroke volume and cardiac output equivalents were reduced by 14% (p less than 0.0005), while calculated peripheral resistance increased significantly. The present study fails to support the hypothesis that preload reduction by tourniquets improves LV function.
传统上，旋转止血带是治疗急性肺水肿的一部分。然而，其有效性受到了质疑。因此，采用放射性同位素技术，对26例心肌梗死后左心室（LV）功能不全患者在使用60 mmHg压力进行静脉闭塞后腿部血容量的增加情况进行了直接评估。在连续15秒的间隔内，平均放射性核素计数的增加（反映闭塞远端腿部的血容量）从闭塞前的值显著增加了46±26%（p<0.0005）。因此，即使在左心室衰竭的情况下，也能实现血液的满意滞留。然而，平均射血分数略有但显著地从0.23±0.10降至0.21±0.10（p<0.05），26例患者中有18例出现了这种下降。左心室舒张末期和收缩末期容积当量倾向于略有下降，但并非所有患者都是如此。平均每搏量和心输出量当量减少了14%（p<0.0005），而计算出的外周阻力显著增加。本研究未能支持止血带降低前负荷可改善左心室功能这一假设。
