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， 止血带 骨骼肌缺血将通过以下方式进行验证： 犬前外侧肌血流量和组织p02的测量 车厢 提供无血视野的最小止血带压力将 被确定。 肌肉和神经功能的丧失将与 止血带应用持续时间。 远端组织坏死 止血带将通过最新开发的骨骼技术进行定量 肌肉. 这些基本的相关性将应用于临床使用的 四肢手术中的止血带 我们以前的研究组织液压力和加压时间变量 骨筋膜室综合征的病理生理学研究表明， 坏死可以通过锝-99焦磷酸亚锡的摄取来定量， 组织钙水平、血浆肌酸磷酸激酶和组织学 相互关联 此外，组织坏死的不可逆性可以是 通过对肌肉和神经功能的短期和长期研究确定， 结合组织学评价。 这里提出的toruniquet研究检查了缺血-长期 只有变量。 沿着对缺血后心肌坏死和功能的研究 组织，将直接遵循控制组织液体平衡的所有压力 毛细导管、微穿刺、血浆渗透压和中空纤维膜 技术. 这些调查应提供足够的数据，以确定 缺血的临界持续时间，可产生显著的不可逆坏死 在止血带远端的组织中 目前，定量信息 关于肢体手术期间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.