Protective effect of continuous slow relaxation of tourniquet for patients with limb ischemia reperfusion inj ury

Guo Junyan; Pi Hongying; Wang Jianrong

doi:10.3969/j.issn.10096493.2015.16.015

Abstract：Objective:To probe into the protective effect of continuous slow relaxation of tourniquet for patients with limbs ischemic reperfusion inj ury.Methods:With the experimental research method,a total of 1 8 beagle dogs were randomly divided into sham operation group (group S),the fast relaxation group (group RR),contin-uous slow relaxation group(SR group).In RR group and SR group after continuing to tie a tourniquet for 3 h, the patients in both groups respectively took fast relaxation and slow relaxation method to release tourniquet, then to observe the changes of reperfusion artery/tissue blood flow,mean arterial pressure,heart rate,skeletal muscle tissue malondialdehyde(MDA),changes in superoxide dismutase(SOD)and serum lactate dehydrogen-ase(LDH),endothelin 1 (ET 1 )and pathological skeletal muscle.Results:After relaxing tourniquet,compa-ring with S group,the arterial blood flow and tissue blood flow of RR group and SR group increased rapidly,and the mean arterial pressure decreased significantly;heart rate increased,and its extent of change in SR group was smaller than that of RR group(P<0.05 or P<0.01);after block for 3 h,tissue MDA,serum LDH and ET 1 began to rise,the content of SOD decreased,and its change in SR group was significantly lower than that in RR group(P<0.05 or P<0.01).Tissue sections and electron microscopy showed that after relaxing tourniquet the muscle cell edema was obvious and with interstitial vascular dilatation and congestion,inflammatory cell infiltra-tion,mitochondrial swelling and dissolution,inflammatory reaction in RR group was obviously aggravated com-pared with that in group SR.Conclusion:By continuous slow relaxing tourniquet method is helpful to maintain the stability of blood circulation,reduce lipid peroxidation and the degree of inj ury of vascular endothelium, which has a protective effect for limb ischemia reperfusion inj ury.