远端缺血预适应的临床实践探索

Clinical practice exploration of remote ischemic preconditioning

远端缺血预适应(RIPC)是近些年新兴起的一种临床治疗新方法、新技术。它是用血压计袖带或压力治疗仪,在患者的四肢某部位施加一定压力,造成缺血处理后,诱导其机体内部产生一种强大的多器官保护机制,以避免、抵抗或缓解今后发生的严重,甚至致死的心脑血管缺血事件。本文以中西医融合观,阐明了远端缺血预适应的发现和认知的历程,重点是通过大量病例探索它在临床上的实用价值和对某些疾病疗效的评估。结果表明,远端缺血预适应对医学无法解释的症状、临界高血压、轻型高血压,单独使用,疗效较好;对稳定型心绞痛,作为辅助治疗,效果满意;远端缺血预适应长期使用,对改善慢性病患者的一般情况有益。本文结合国内外实验室和临床的丰富资料,对远端缺血预适应的作用机理进行了深入探讨,梳理了其适应证、禁忌证和须注意的事项,草拟了远端缺血预适应的使用方法。

Remote ischemic preconditioning （R1PC） is a new method of clinical treatment and a new technology rising in recent years. The method is to use the sphygmomanometer cuff or pressuretherapeutic apparatus to generate a certain pressure at a part of the limbs to cause ischemia and then to induce the body to produce a more powerful multiple organ protection mechanism in order to avoid, resist, or alleviate the occurrence of severe and fatal cardiovascular and cerebrovascular ischemic events.Based on fusion of Chinese and western medicine theory, this paper illuminated the discovery and cognitive process of the R1PC, and the key was through a lot of cases to explore its practical values in the clinic and evaluate its efficacy on certain diseases. The results showed the R1PC had better curative effects on some medical unexplained symptoms, critical hypertension, mild hypertension, and the effect was satisfied for stable angina as an adjuvant therapy. Further, The R1PC was beneficial to improve the general situation of chronic diseases when used for a long time.Based on the laboratory and clinical dataat domestic and abroad, the action mechanism of R1PC is explored thorough in-depth discussion, and its indications, contraindications and precautions were combed. Moreover, the methods of use of the R1PC are drafted.