林 昌俊 医学部附属病院, 医員
柴田 雅也 岐阜大学, 医学部附属病院, 医員
SENGA Syoushi Gifu univ.school of Med.First dept.of Surg.assistant professor, 医学部附属病院, 講師 (20226690)
安田 博之 岐阜大学, 医学部附属病院, 医員
YASUDA Hirouki Gifu univ.school of Med.First dept.of Surg.committee
SIBATA Masaya Gifu univ.school of Med.First dept.of Surg.committee
|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1995 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1994 : ¥1,500,000 (Direct Cost : ¥1,500,000)
Myonephropathic-metabolic syndrome (MNMS) following after reperfusion injury in the skeletal muscle is critical and lethal complication in acute arterial occlusive disease. For avoidance and prediction of MNMS,instantaneous assesment of ischemic damage of the skeletal muscle before reperfusion is essential. We performed experimental and clinical studies with measurement of electrical character in the skeletal muscle to assess ischemic damage and reperfusion injury in lower limbs.
1.In eleven anesthetized dogs, the bilateral hindlimbs were squeezed at the inguinal region to make ischemia and they were reperfused after various intervals, which were Oh(Group I,N=3), 1h(Group II,N=3), 3h(Group III,N=4), 6h(Group IV,N=1). Electrical conductivity(G) of the skeletal muscles in hindlimbs was measured with an LCR meter. Change of G in hindlims during 3 hours of reperfusion(DELTA3G) were measured. Serum CPK and aldlase (Ald) were measured intermittently from preischemia to 10 hours reperfusion.
In patients with AAA (N=3), ASO(N=1), or acute arterial occlusion(n=1), G of lower extremities was measured from arterial clamp to declamp. Serum CPK was measured during surgical operation and postoperative period, intermittently.
In Experimental study, G was decreased during ischemia, and increased after reperfusion. In group I and II,CPK and Ald showed no significant changes, but in group III and IV,they increased significantly. In dogs indicated under 2.1mS/cm of DELTA3G,CPK and Ald were not increased after reperfusion. but in dogs indicated with more than 2.1mS/cm of DELTA3G they increased significantly after reperfusion. CPK and Ald at 10 hours after reperfusion correlated well (P<0.001) to DELTA3G in dogs whose DELTA3G were more than 2.1mS/cm.
In clinical study, only AAO patient showed significant increase of G in lower extremities and he showed higher CPK than the other patients.
We suggested that measurement of G may provide monitoring of ischemic injury of the skeletal muscle and reperfused phase, and be applicable to prediction of the skeletal muscular reperfusion injury. Less