膝关节镜术中使用止血带对肌酸激酶等血生化及血常规指标的影响

The Influence of Tourniquet Use During Knee Arthroscopy on RoutineBlood Test and Blood Biochemical Indicators

目的检测膝关节镜手术中止血带的使用对围手术期血红蛋白变化、肝肾功能以及肌酸激酶等指标的影响,以评估止血带使用对检验学指标的影响。方法对2020年1月至2021年12月间我院因膝关节半月板损伤接受膝关节镜手术的患者进行了回顾性分析,其中止血带组88例,无止血带组56例。对患者的基线数据、术前及术后第一天的血红蛋白(HGB)及红细胞压积(HCT)差值、术前及术后第一天谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酐(Cr)、肌酸激酶(CK)及肌酸激酶同工酶MB(CK-MB)进行测定并行统计学分析,以P<0.05为差异有统计学意义。结果两组间的手术前后HGB及HCT差值差异无统计学意义(P>0.05)。术前两组患者的CK水平差异无统计学意义,术后止血带组的CK水平明显高于非止血带组,异常患者比例也明显高于非止血带组(P<0.05)。两组间术前及术后的ALT、AST、Cr、CK-MB水平差异无统计学意义。结论止血带的使用并不能减少围手术期失血程度,且可导致术后CK的明显升高,提示其造成了一定程度的肌肉损伤。

Objective To examine the influence of perioperative tourniquet use on hemoglobin changes,liver and kidney function,and creatine kinase in knee arthroscopy to assess its effects on laboratory parameters in such operations.Methods A retrospective analysis was performed on patients who underwent knee arthroscopy for knee meniscal injury in our hospital during January,2020 and December,2021,including 88 cases in the tourniquet group and 56 cases in the non-tourniquet group.Baseline data,preoperative and first day postoperative hemoglobin(HGB)and hematocrit(HCT)deviations,preoperative and first day postoperative alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr)creatine kinase(CK)and creatine kinase isoenzyme MB(CK-MB)of patients were measured and statistically analyzed,with P<0.05 considered as statistically significant.Results There was no statistically significant difference in the pre-and postoperative HGB and HCT levels between the two groups(P>0.05).No significant difference was found in CK levels between the two groups before surgery,while postoperative CK levels were significantly higher in the tourniquet group than in the non-tourniquet group,and the proportion of CK abnormal patients was also significantly higher than in the non-tourniquet group(P<0.05).There was no statistically significant difference in preoperative and postoperative ALT,AST,Cr,and CK-MB levels between the two groups.Conclusion The use of tourniquets does not reduce the degree of perioperative blood loss and can lead to a significant increase in postoperative CK,suggesting that it causes some extent of muscle impairment.