气囊止血带阻断下肢血流压力值的研究  

Study of pressure of lower extremity blood flow blocked by pneumatic tourniquet

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]汕头大学医学院附属粤北人民医院手术室,广东省韶关市512025 [2]汕头大学医学院附属粤北人民医院骨二科,广东省韶关市512025 [3]汕头大学医学院附属粤北人民医院影像诊断科,广东省韶关市512025

出　　处：《中华护理杂志》2006年第11期965-968,共4页Chinese Journal of Nursing

摘　　要：目的探讨下肢手术时气囊止血带适宜的个体充气压力。方法选择30例健康成年志愿者，按站立时右大腿围分为S组（〈45cm）、M组（45～60cm）、L组（〉60cm），用彩色多普勒超声血流显像仪分别测定右胭动脉血流100％和50％阻断时的气囊止血带充气压力值。以下肢周径和测定值为依据确定手术时充气压力，以缚扎止血带处肢体周径（cm）作为个体充气压力（kPa）值，最大值≤50kPa。用上述方法应用于下肢手术700例，观察术中创面的止血效果和术后止血带损伤发生情况。结果30例右侧胭动脉血流100％和50％阻断时气囊止血带充气压力参考值分别为：S组（35．70±3．16）kPa和（18．90±2．77）kPa，M组（34．40±2．72）kPa和（19．10±2．18）kPa，L组（39．60±1．90）kPa和（22．90±3．21）kPa，各组阻断压力差异有统计学意义（P〈O．01）。下肢手术应用700例，止血效果达优690例，良10例，术后均无止血带损伤。结论以下肢缚扎止血带处肢体周径（cm）作为气囊止血带充气压力参考值（kPa），是下肢手术适宜的个体充气压力。Objective To investigate the suitable pressure of pneumatic tourniquet used in patients undergoing lower extremity surgeries. Method A total of 30 healthy adult volunteers were divided into three group according to the circumference of right thigh in standing posture： groupS（〈45cm）, group M（45-60cm）, and group L（〉60cm）. Pressure of the tourniquet was measured by color Doppler flow imaging（CDFI）when the right popliteal artery flow was blocked by 50% and 100% Individual pressure was determined by the measurement and right thigh circumference： The pressure was set at the number of the thigh circmnference in centimeters but no higher than 50 kPa. 700 cases who underwent lower extremity surgery had the tourniquel pressure set according to this method. The effectiveness of the tourniquet and postoperative tourniquet related complications were observed. Results The pressures for blocking 100% and 50% right popliteal artery flow were （ 35.70± 3.16 ） kPaand （ 18.90±2.77 ） kPa respeetivelyin group S, （ 34.40±2.72 ） kPa and （ 19.10±2.18 ） kPa respectively in group M, （39.60± 1.90）kPa and （22.90±3.21）kPa in respectively in group L. The tourniquet worked well in 690 eases . There was no tour niquet related complications. Conelusions Taking the circumference （centimeters） where the tourniquet is fastened as the reference value for tourniquet pressure （ kPa ） is suitable for individuals undergoing lower extremity surgery.

关 键 词：止血带 下肢 周径 压力 外科手术 

分 类 号：R472[医药卫生—护理学]