清醒健康志愿者短暂肢体缺血的可接受性和安全性评价  

Assessment for safety and acceptability of transient limb ischemia in conscious healthy volunteers

作　　者：张南荣[1] 周燕[1] 靳三庆[1] 庞婷[1] 雷泓[1] 

机构地区：[1]中山大学附属第六医院麻醉科,广东广州510655

出　　处：《中国病理生理杂志》2011年第4期666-671,共6页Chinese Journal of Pathophysiology

基　　金：广东省自然科学基金资助项目(No.07001664)

摘　　要：目的:评估清醒健康志愿者短暂肢体缺血的安全性和可接受性。方法:选择60名20-30岁健康志愿者,男女各半,利用血压计袖带的充气/放气进行3个循环的非优势上肢缺血再灌注,每个循环为缺血5min/再灌注5min,充气压力为200mmHg。此过程中持续监测心率、血压、脉搏氧饱和度等生命体征,操作结束后用调查问卷(主要以0-10分的数字评分法为量化尺度)评估可接受性和不适感觉,于第3d重复进行1次同样的问卷调查,以评估问卷的可信度,保证结果的可靠性。结果:短暂肢体缺血中,志愿者的心率、血压和脉搏氧饱和度均波动在正常范围内。56.6%男性和66.7%女性的可接受度为7-8分,56.7%志愿者的舒适程度在4-6分,86.7%志愿者认为麻木感是最主要的不适感觉,46.6%男性和50.9%女性的麻木感评分在7-8分,每个循环肢体缺血中麻木感持续2-5min,再灌注后1-2min消失。男女间的可接受度和不适感觉无显著差异。问卷具有良好的重测信度(组内相关系数为0.990)。结论:短暂肢体缺血是一种乐于被清醒健康志愿者所接受的、安全的远程缺血处理方法。AIM：To assess the safety and acceptability of transient limb ischemia in conscious healthy volunteers. METHODS：Sixty healthy volunteers（30 male and 30 female）aged from 20 to 30 years old were enrolled.The transient limb ischemia protocol consisted of 3 cycles of left upper arm ischemia and reperfusion induced by inflating a blood pressure cuff to a pressure of 200 mmHg for 5 min,and then deflating the cuff for 5 min.Physiological variables including heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）and pulse oxygen saturation（SpO_2） were monitored and recorded during the procedure to assess the safety.A questionnaire was completed by every volunteer right after the protocol and repeated 2 days later.An 11-point numeric rating scale（NRS）was used to assess the acceptability and main discomforts in the questionnaire.Intraclass correlation coefficients（ICC）were calculated to analyze the reliability of the questionnaire.RESULTS：HR,SBP,DBP and SpO_2 fluctuated in normal range.56.6%male and 66.7%female chose 7-8 points for the acceptability and 56.7%of the volunteers chose 4-6 points for the degree of comfort during transient limb ischemia.Numbness was the predominant discomfort in 86.7%volunteers,which lasted for 2 -5 min during every cycle of limb ischemia and disappeared 1-2 min after reperfusion.No difference between male and female in the assessment of acceptability and discomforts was observed.Our questionnaire had excellent test-retest reliability as ICC calculation was 0.990.CONCLUSION：Transient limb ischemia is a safe and well accepted model for remote ischemic preconditioning in conscious healthy volunteers.

关 键 词：缺血预处理 短暂肢体缺血 健康志愿者 安全性 可接受性 

分 类 号：R459.9[医药卫生—治疗学]