卢卫忠,刘正敏,胡志芬,曹洪辉,冉金伟,陈忠余,傅洪

• 1:重庆市中医院

摘要(Abstract)：

目的观察复方甘草酸苷对肢体缺血再灌注损伤的作用,探索延长肢体使用止血带的最大限度时间。方法 48例患者随机分为常规使用止血带组(A组)、复方甘草酸苷组(B组)、复方甘草酸苷处理后止血带延长0.5 h组(C组)和复方甘草酸苷处理后止血带延长1.0 h组(D组)各12例。除A组外,各组给予复方甘草酸苷术前静滴。观察止血带加压前、再灌注0.5 h、1.5 h、3 h、24 h和72 h分别检测血清丙二醛(MDA)、肌酸磷酸激酶(CPK)、谷草转氨酶(GOT)和乳酸脱氢酶(LDH)的含量以及超氧化物歧化酶(SOD)活性。结果随着止血带加压肢体后再灌注时间的延长,血中MDA、CKP、GOT和LDH逐渐上升,SOD活性逐渐降低。在A组,与缺血前(止血带加压前)比较,肢体缺血再灌注(手术结束完全松止血带)后30 min、90 min、3 h、24 h和72 h,血清MDA、CPK、GOT和LDH含量升高,24 h达到高峰,至72 h降至再灌注后3 h的水平;而SOD活性呈进行性下降,24 h降至最低,至72 h恢复至再灌注后3 h的水平。B组和C组再灌注后各同时相点内,血清MDA、CPK、GOT和LDH含量明显低于A组(均P<0.05),SOD活性明显高于A组(均P<0.05)。与A组相比,再灌注后3 h、24 h和72 h,D组血中MDA、CKP、GOT和LDH含量以及SOD活性无明显差别(均P>0.05)。与B组相比,再灌注后3 h、24 h和72 h,C组和D组的血清MDA、CPK、GOT和LDH含量明显升高(均P<0.05),SOD活性降低(均P<0.05)。与C组相比,再灌注后3 h、24 h和72 h,D组的血清MDA、CPK、GOT和LDH含量明显升高(均P<0.05),SOD活性降低(均P<0.05)。结论复方甘草酸苷对肢体缺血再灌注损伤有保护作用,通过其保护作用,可以将肢体使用止血带时间从常规的1.5 h延长0.5 h和1.0 h,最佳延长使用0.5 h。

关键词(KeyWords)： 缺血再灌注损伤;止血带;甘草酸苷;四肢;自由基

Abstract:

Keywords:

基金项目(Foundation): 重庆市卫生局中医药科技项目(2013-2-156)

作者(Author): 卢卫忠,刘正敏,胡志芬,曹洪辉,冉金伟,陈忠余,傅洪

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