Brunelli G A, Brunelli G R
Department Orthopaedic, Medical School, University, Brescia, Italy.
Int Angiol. 1995 Sep;14(3):253-63.
A multidisciplinary study was done to examine the following: (a) pathophysiological changes in muscle and nerve response following different periods of normothermic and cold ischemia; (b) alterations in the release of enzymes (K, LDH), CA++, K=and lactate under these conditions; and (c) histological alterations of vessels, nerves and muscles after different periods of normothermic and cold ischemia. The results demonstrate that hypothermic ischemia greatly reduces both the leakage of enzymes, cellular damage and pathological responses. We infer that amputated parts containing muscular masses may be replanted with good prognosis for satisfactory functional results within 4-5 hours at room temperature. By reducing the temperature, the time between cooling and revascularization may be doubled. Parts without muscles may be replanted 10-12 hours after normothermic ischemia and up to 24 hours or even longer after cold ischemia.
开展了一项多学科研究，以检验以下内容：(a) 不同时长的常温缺血和冷缺血后肌肉与神经反应的病理生理变化；(b) 在这些条件下酶（钾、乳酸脱氢酶）、钙离子、钾离子和乳酸释放的改变；以及 (c) 不同时长的常温缺血和冷缺血后血管、神经和肌肉的组织学改变。结果表明，低温缺血极大地减少了酶的泄漏、细胞损伤及病理反应。我们推断，含有肌肉团块的断肢在室温下4至5小时内进行再植，有望获得良好的预后及满意的功能结果。通过降低温度，冷却与血管再通之间的时间可延长一倍。无肌肉的断肢在常温缺血后10至12小时进行再植，冷缺血后可长达24小时甚至更长时间。
