高渗氯化钠羟乙基淀粉40注射液对下肢缺血再灌注损伤的影响

目的探讨高渗氯化钠羟乙基淀粉40（HSH40）注射液对止血带引起的下肢缺血再灌注损伤的影响。方法将20例ASAI-Ⅱ级择期全麻行单膝关节置换手术的患者随机分为HSH40注射液组（n=10）、对照组（n=10）,检测止血带充气前及放气后5、10、20min血清肌酸磷酸激酶（CPK）、乳酸脱氢酶（LDH）活性、丙二醛（MDA）含量。结果两组患者与充气前对比,患者血清LDH在放气后5min下降,10、20min逐渐恢复,血清MDA在放气后5min升高,10、20min逐渐恢复,两组的LDH和MDA含量在各时点比较无统计学意义（P〉0.05）,CPK两组在松止血带前后亦无统计学意义（P〉0.05）。结论全麻下行下肢骨科手术时使用止血带,患者血清LDH和MDA有一定变化,松止血带后5min内影响最大,为一过性改变;和对照组比较,HSH40对MDA、LDH、CPK的影响差异无统计学意义。

Effect of hypertonic sodium chloride hydroxyethyl starch 40 injection on the ischemia reperfusion injury of lower extremity

Objective To investigate the effects of hypertonic sodium chloride hydroxyethyl starch 40 injection on the tourniquet-induced lower extremity ischemia-reperfusion.Methods 20（ASA I-Ⅱ） cases who underwent selective TKR（total knee replacement） under general anesthesia were randomly divided into 2 groups： HSH 40 group（n=10） and control group（n=10）.CPK,LDH and MDA were measured before inflation and 5,10 and 20 minutes respectively after deflation of tourniquet.Results Comparing with pre-inflation of tourniquet,LDH in 2 groups decreased at 5 minutes after deflation and began to gradually recover at 10,20 minutes after deflation and MDA in 2 groups started to increase at 5 minutes after deflation and gradually recovered at 10 to 20 minutes after deflation.LDH and MDA in 2 groups did not have statistical difference at each time point（P〉0.05）.CPK in 2 groups did not change dramatically before and after deflation of tourniquet.Conclusion During orthopedic surgery for lower extremities under general anesthesia,tourniquets have a certain effect on the serum LDH and MDA.The greatest effect happens within the 5 minutes after deflation and is transient.MDA,LDH and CPK in HSH40 group are not affected significantly compared with those in control group.