不同止血带时间止血带下及其以远肌损伤形态学观察

The Morphology Observation of the Muscle Injuries Induced Beneath and Distal to A Pneumatic Tourniquet with Different Time

本文报告15只健康家犬的30条后腿,在气囊止血带40kPa压力下,扎止血带1、2、4小时,观察了缺血期、止血带后2小时、2天和6天止血带下及其以远不同部位肌肉组织学和超微结构变化,并对止血带时间、压力及损伤机理进行了讨论。结果表明止血带直接机械性压迫是肢体止血带损伤的主要原因。作者认为止血带压力40kPa、时间1小时较为安全,可使组织损伤减少到最低程度。

This study was designed to observe the changes of histology and infrastructure of skeletal muscle injuries induced beneath and distal to a pneumatic tourniquet applied to the 30 hind limbs of 15 healthy adult dogs for 1,2 and 4 hours with a cuff inflation pressure of 40 kPa. It was peformed in all groups at the is-chemic period after tourniquet inflation 2 hours,2 and 6 days after final release of the tourniquet that samples of histology and electron microscopic examination of muscle were taken from different area of beneath and distal to the tourniquet. The time .pressure and mechanism of the injuries were discussed also. The experimental study showed that direct mechanical compression of tourniquet was the main mechanism of tourniquet induced limb muscle injury. Use of the lowest possible inflation pressure and time for a limited duration should minimize the degree of tissue injury caused by tourniquet application. One hour of conti-neous tourniquet applicaion with a cuff inflation pressure of 40 kPa was recommended as a safe period of tourniquet hemostasis at clinical practice.