Walker P M
Can J Surg. 1986 Sep;29(5):340-2.
Acute arterial occlusion may cause prolonged ischemia of the lower extremity. Since skeletal muscle is the major component, its reaction to the stress of ischemia best determines the final outcome for the limb. The combination of cellular damage during the period of ischemia and its exacerbation during reperfusion may result in the production of skeletal muscle necrosis. The relative resistance of skeletal muscle to normothermic ischemia is related to its low resting energy demands and large intracellular stores of available energy. If the period of ischemia is long enough, restoration of the circulation may exacerbate cellular damage, due in part to washout of adenine nucleotide precursor, free-radical-mediated injury and finally calcium-dependent necrosis. In addition to the clinical manifestation of local swelling, rhabdomyolysis can lead to systemic complications of hyperkalemia, renal failure or death. Therapeutic interventions aimed at reducing reperfusion damage may result in the salvage of functional lower limbs that might otherwise be lost.
急性动脉闭塞可能导致下肢长时间缺血。由于骨骼肌是主要组成部分，其对缺血应激的反应最能决定肢体的最终结局。缺血期间的细胞损伤及其在再灌注期间的加剧相结合，可能导致骨骼肌坏死。骨骼肌对常温缺血的相对耐受性与其低静息能量需求和大量细胞内可用能量储备有关。如果缺血时间足够长，恢复循环可能会加剧细胞损伤，部分原因是腺嘌呤核苷酸前体的冲洗、自由基介导的损伤以及最终的钙依赖性坏死。除了局部肿胀的临床表现外，横纹肌溶解可导致高钾血症、肾衰竭或死亡等全身并发症。旨在减少再灌注损伤的治疗干预措施可能会挽救原本可能失去功能的下肢。
