TOURNIQUET-ISCHEMIA EFFECTS ON SKELETAL MUSCLE AND NERVE

研究目的是研究缺血对远端组织的影响。 一种实用的止血带。骨骼肌缺血将通过以下方式得到证实 犬前外侧肌血流量和组织P02的测量 车厢。最小的止血带压力将提供一个无血的视野 要下定决心。肌肉和神经功能的丧失将与 止血带使用时间。关节远端组织的坏死 止血带将通过最新开发的骨骼技术进行量化 肌肉。这些基本相关性将应用于临床应用。 四肢手术中的止血带。 我们先前对组织液压力和加压时间变量的研究 在筋膜间室综合征的病理生理学上表明骨骼肌 坏死可以用~(99)Tm摄取焦磷酸亚锡来量化， 组织钙水平、血浆肌酸磷酸激酶与组织学 相互关联。此外，组织坏死的不可逆性可以 由短期和长期的肌肉和神经功能研究确定的 结合组织学评估。 在这里提出的TORONIET研究检验了缺血期的影响。 仅限变量。随着对缺血后坏死和功能的研究 组织，所有控制组织液体平衡的压力将直接跟随 采用导尿管、微穿刺法、血浆渗透压法和中空纤维膜 技巧。这些调查应该提供足够的数据来确定 严重的缺血持续时间，导致严重的、不可逆转的坏死 在止血带远端的组织中。目前，量化信息 关于肢体手术中长时间使用止血带的影响 缺乏。

The research objective is to study the effects of ischemia on tissues distal to an applied tourniquet. Skeletal-muscle ischemia will be verified by measurements of blood flow and tissue p02 in the canine anterolateral muscle compartment. A minimum tourniquet pressure that provides a bloodless field will be determined. Loss of muscle and nerve function will be correlated with duration of tourniquet application. Necrosis in tissues distal to the tourniquet will be quantitated by recently-developed techniques for skeletal muscle. These basic correlates will be applied to the clinical use of tourniquets during limb surgery. Our previous studies of tissue fluid pressure and pressurization-time variables in the pathophysiology of the compartment syndrome indicate that skeletal-muscle necrosis can be quantified by technetium-99 stannous pyrophosphate uptake, tissue calcium levels, plasma creatine phosphokinase and histological correlates. In addition, the irreversibility of the tissue necrosis can be determined by short- and long-term studies of muscle and nerve function in conjunction with histological evaluations. The toruniquet studies proposed here examine the effects of ischemic-term variables only. Along with studies of necrosis and function of post-ischemic tissue, all pressures governing tissue fluid balance will be followed directly by wick catheter, micropuncture, plasma osmometric and hollow-fiber membrane techniques. These investigations should provide sufficient data to determine a critical duration of ischemia which produces significant, irreversible necrosis in tissues distal to the tourniquet. At present, quantitative information regarding the effects of prolonged tourniquet application during limb surgery is lacking.