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[肢体手术中的缺血预处理:实验研究]

[Ischemic preconditioning in surgery of extremities: experimental studies].

作者信息

Gürke L, Marx A, Harder F, Heberer M

机构信息

Departement Chirurgie, Kantonsspital der Universität, Basel.

出版信息

Chirurg. 1996 Aug;67(8):839-42. doi: 10.1007/pl00002527.

Abstract

Ischemic preconditioning (IP), using one or more brief periods of ischemia, each followed by a short reperfusion phase, improves tolerance of subsequent sustained ischemia in different organs. The aim of this experimental study was to evaluate the effects of IP on postischemic function in skeletal muscle. Right hindlimbs of anesthetized rats were pretreated with three cycles each of 10 min of ischemia and 10 min of reperfusion (n = 12). Non-preconditioned animals (n = 12) served as controls. These hindlimbs were then subjected to 3 h of ischemia and 2 h of reperfusion. IP resulted in a significant increase in postischemic skeletal muscle force (240 +/- 47 mN vs 409 +/- 63 mN), force-time integral (1081 +/- 242 mNs vs 2546 +/- 481 mNs) and endurance (29.6 +/- 3.4 s vs 48.0 +/- 5.0 s). These data support the potential of IP to reduce postischemic skeletal muscle damage in surgery of the extremities using tourniquet ischemia. The concept deserves clinical evaluation.

摘要

缺血预处理(IP)通过一次或多次短暂的缺血期,每次缺血后紧接着短暂的再灌注期,可提高不同器官对随后持续缺血的耐受性。本实验研究的目的是评估缺血预处理对骨骼肌缺血后功能的影响。对麻醉大鼠的右后肢进行三个周期的预处理,每个周期包括10分钟缺血和10分钟再灌注(n = 12)。未进行预处理的动物(n = 12)作为对照。然后对这些后肢进行3小时缺血和2小时再灌注。缺血预处理导致缺血后骨骼肌力量显著增加(240±47 mN对409±63 mN)、力量-时间积分(1081±242 mN·s对2546±481 mN·s)和耐力增加(29.6±3.4秒对48.0±5.0秒)。这些数据支持缺血预处理在使用止血带缺血的肢体手术中减少缺血后骨骼肌损伤的潜力。这一概念值得进行临床评估。

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