肢体缺血-再灌注损伤对凝血功能的影响

Effects of limb ischemia-reperfusion injury on blood coagulation

目的探讨肢体缺血-再灌注损伤(I-RI)对患者凝血功能的影响。方法 18例择期在硬膜外麻醉下行单侧膝关节镜手术治疗患者,术中使用充气式止血带,肢体缺血时间(42±6)min。分别于止血带充气前(T1)、肢体缺血30min(T2)、再灌注3min(T3)和30min(T4)抽取静脉血,应用血栓弹力描记图(TEG)检测凝血功能。结果与T1时比较,TEG显示反应时间(R值)和凝固时间(K值)降低、凝固角(α角)和血栓最大幅度(MA值)增大,但其改变均在正常值范围,且与其他时点相比差异无统计学意义。结论肢体I-RI对患者凝血功能没有显著影响。

Objective To investigate the effects of limb ischemia-reperfusion injury（I-RI） on blood coagulation.Methods Eighteen patients scheduled for unilateral knee arthroscopy surgery under epidural anesthesia were treated with an inflatable tourniquet to ptoduce ischemia for （42±6） min.Venous blood was taken before tourniquet inflation,at 30 min during ischemia,3 min and 30 min during reperfusion for measuring blood coagulation by thrombelastography（TEG）.Results TEG showed the decreases in reaction time（R value） and coagulation time（K value）,and the increases in alpha angle（α） and maximal amplitude（MA）,which were all within the normal limits and had no significant differences among four time points of testing.Conclusion I-RI of the limbs has no significant effects on blood coagulation.