Adu-Gyamfi Y, Sankarankutty M, Marwa S
Department of Anaesthesiology, King Faisal University, College of Medicine, Dammam, Saudi Arabia.
Can J Anaesth. 1993 Jan;40(1):24-7. doi: 10.1007/BF03009313.
Fifteen patients, 13 male and two female, known to be carrying the sickle-cell gene (12 HbSS and 3 HbAS), who were undergoing operations requiring a bloodless field, were included in the study. Of the 12 with HbSS, seven had haemoglobin A1 component of between 11 and 27%, three had fetal haemoglobin ranging from 5.7 to 29% and the remaining two had increased haemoglobin A2 concentrations suggesting a beta non-thalassaemia combination. All had a tourniquet applied to the appropriate limb and were given general anaesthesia with moderate hyperventilation throughout the procedure. The tourniquet inflation time was 61.7 +/- 27.5 min. The mean PaO2 remained above 200 mmHg, mean PaCO2 was less than 37 mmHg, and pH ranged between 7.40 and 7.45. There were no clinically important changes in BP or ECG. All patients made uneventful recoveries and none developed sickle-cell crises. It is suggested that it is safe to use tourniquet in patients with sickle-cell disease provided optimum acid-base status and oxygenation are maintained throughout the procedure.
本研究纳入了15名已知携带镰状细胞基因的患者，其中13名男性，2名女性（12例血红蛋白SS型和3例血红蛋白AS型），他们正在接受需要无血手术视野的手术。在12例血红蛋白SS型患者中，7例血红蛋白A1成分在11%至27%之间，3例胎儿血红蛋白含量在5.7%至29%之间，其余2例血红蛋白A2浓度升高，提示为β地中海贫血合并症。所有患者均在适当肢体上使用了止血带，并在整个手术过程中接受了全身麻醉和适度过度通气。止血带充气时间为61.7±27.5分钟。平均动脉血氧分压保持在200 mmHg以上，平均动脉血二氧化碳分压小于37 mmHg，pH值在7.40至7.45之间。血压或心电图无临床重要变化。所有患者均顺利康复，无一例发生镰状细胞危象。研究表明，在整个手术过程中保持最佳酸碱状态和氧合的情况下，镰状细胞病患者使用止血带是安全的。
