上肢手术气囊止血带个体充气压力的研究  

A study on pressure of pheumatic tourniquet in patients undergoing upper extremity surgery

作　　者：李清梅[1] 贝抗胜[2] 邹金英[1] 何玉珍[1] 蔡志敏[1] 肖雨雄[3] 

机构地区：[1]广东省韶关市汕头大学医学院附属粤北人民医院手术室,512025 [2]广东省韶关市汕头大学医学院附属粤北人民医院手外科,512025 [3]广东省韶关市汕头大学医学院附属粤北人民医院影像诊断科,512025

出　　处：《中华手外科杂志》2006年第2期90-91,共2页Chinese Journal of Hand Surgery

摘　　要：目的探讨上肢手术时气囊止血带适宜的个体充气压力。方法对30例健康成年志愿者,按右上臂周径大小分为S组(≤25cm)、M组(26～30cm)和L组(＞30cm),用彩色多普勒超声血流显像仪分别测定肱动脉血流100%和50%阻断时气囊止血带充气压力值。以周径和测定值为依据确定充气压力：周径≤25cm者,充气压力为25 kPa(IkPa=7．5mm Hg),＞25cm者。以肢体周径(cm)作为个体充气压力(kPa)值,最大值≤40kPa。用上述方法应用于上肢手术150例,并观察术中创面止血效果和术后止血带副损伤发生情况。结果30例右侧肱动脉血流100%和50%阻断时气囊止血带充气压力参考值分别为：S组[(19．17±1．95)kPa,(?)±s,下同]和(11．50±1．98)kPa,M组(21．18±2．09)kPa和(13．45±1．86)kPa,L组(27．00±4．12)kPa和(16．43±1．13)kPa,各组阻断压力差异有统计学意义(P＜0．01)。手术应用150例中,上臂周径平均为(28．13±3．53)cm,气囊止血带充气压力平均为(28．19±3．03)kPa。手术应用个体充气压力,止血效果优147例,良3例,术后均无止血带副损伤。结论以上肢缚扎止血带处肢体周径(cm)作为充气压力的参考值(kPa),是上肢手术适宜的个体充气压力。Objective To investigate the suitable pressure of pheumatic tourniquet used in patients undergoing upper extremity surgeries. Methods A total of 30 adult volunteers were divided into three groups according to the arm circumference： group S （≤25 cm）, group M （26 - 30 cm）, and group L （ 〉 30 cm）. Pressure of the tourniquet was measured when the brachial artery flow was blocked by 50% and 100% under color Doppler detection. Individual pressure was determined by the measurement and arm circumference. For individuals with an arm circumference ≤ 25 cm, the pressure was set at 25 kPa. For individuals with an arm circumference 〉 25 cm, the pressure was set at the number of the arm circumference in centimetres but no higher than 40 kPa. 150 cases who underwent upper extremity surgery had the tourniquet pressure set according to this method. The effectiveness of the tourniquet and postoperative tourniquet related complications were observed. Results The pressures for blocking 50% and 100% brachial artery flow were （ 11.50 ± 1.98） kPa and （ 19.17 ± 1.95） kPa respectively in group S, （ 13.45 ± 1.86） kPa and （21.18 ± 2.09） kPa respectively in group M, and （ 16.43 ± 1.13） kPa and （27.00 ± 4.12） kPa respectively in group L. In the 150 operated cases the average arm circumference was （28.13 ± 3.53） cm, and the average tourniquet pressure was （28.19 ± 3.03） kPa. The tourniquet worked well in 147 cases. There was no tourniquet related complications. Conclusion Taking the circumference （centimeters） where the tourniquet is fastened as the reference value for tourniquet pressure （kPa） is suitable for individuals undergoing upper extremity surgery.

关 键 词：止血带 上肢 显微外科手术 充气压力 

分 类 号：R658[医药卫生—外科学]