磷酸肌酸钠预先给药对膝关节镜手术患者下肢骨骼肌缺血再灌注损伤的影响

摘要

目的 观察磷酸肌酸钠预先给药在膝关节镜手术中对患者下肢骨骼肌缺血再灌注损伤的影响. 方法 择期拟行膝关节镜手术患者60例,随机均分为对照组( I组)和磷酸肌酸钠组( C组). C组在上止血带前30 min经外周静脉输注磷酸肌酸钠30 mg/kg (溶于100 ml生理盐水) ,输注时间30 min;I组经外周静脉给予生理盐水100 ml. 分别于上止血带前(T1)、松止血带前(T2)、松止血带后30 min(T3)、松止血带后1 h(T4)抽取静脉血,检测血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、乳酸脱氢酶(LDH)、丙二醛( MDA)、超氧化物歧化酶( SOD)水平. 结果 与I组比较,在T2、T3、T4时点,C组IL-1、IL-6、LDH、MDA值明显降低( P<0. 05),SOD明显增高(P<0. 05). 结论 膝关节镜手术中磷酸肌酸钠预先给药可减轻患者下肢骨骼肌缺血再灌注损伤.%Objective To investigate the effect of creatine phosphate sodium ( CP ) on skeletal muscle ischemia reperfusion injury of patients undergoing knee arthroscopic surgery. Methods 60 patients were randomly divided into two groups:control group (n=30) and CP pretreatment group (n=30). In CP group, creatine phosphate so-dium (30 mg/kg) in 100 ml normal saline was infused over 30 min starting from the beginning of operation. In the control group,NS 100 ml was infused instead of CP. Serum IL-1, IL-6, LDH, MDA and SOD level were detected before tourniquet inflation ( T1 ) , before tourniquet release ( T2 ) , 30 min after tourniquet release ( T3 ) , 1 h after tourniquet release (T4), respectively. Results Compared with I group, IL-1, IL-6, LDH, MDA in CP group were significantly decreased ( P<0. 05 ) , SOD was significantly increased ( P<0. 05 ) . Conclusion Pretreatment with CP can protect skeletal muscle against ischemia reperfusion injury in patients undergoing knee arthroscopic sur-gery.