气囊止血带充气压力对下肢手术患者应激反应的影响  

The Relationship Between Tourniquet Pressure and Stress Reaction During Lower Extremity Operation

作　　者：潘甦[1] 夏艳[1] 吕晓霞[1] 叶彤[1] 

机构地区：[1]山东中医药大学附属医院手术室,山东济南250011

出　　处：《护理学杂志》2007年第24期1-3,共3页

基　　金：山东中医药大学附属医院科研基金资助项目(院科字[2005]4号)

摘　　要：目的探讨下肢手术患者术中气囊止血带的合适压力及其对患者应激反应的影响。方法对10例自愿者采用彩色多普勒诊断仪行下肢动脉血循阻断压力试验,确定适宜的止血带压力。根据试验结果对38例择期下肢手术患者采用阻断血循压力(180mmHg)加120mmHg(共300mmHg)缚绑患肢实施手术。于止血带充气前(T0)、充气后即刻(T1)、充气30min(T2)、松止血带后(T3)分别测定患者皮质醇、血糖、胰高血糖素的变化;观察不同时段血压、脉搏、呼吸变化;判断术中止血带使用效果。结果不同时段皮质醇、胰高血糖素比较,差异有显著性意义(均P<0.01);各时段血压、脉搏、呼吸均有不同程度的变化,但差异无显著性意义(均P>0.05);38例患者术中止血带使用达优率100%。结论止血带止血能引起人体应激激素水平的升高,而适宜的压力可减轻患者应激反应。Objective To find the right pressure of tourniquet during operation and examine its influence on the stress reaction of patients, Methods Suitable pressure of tourniquet was determined in 10 volunteers by using color Doppler. Blood hydrocortisone, blood sugar and glucagons were recorded before the inflation of tourniquet（T0 ）, immediately after the inflation （T1）, 30 rain after the inflation of tourniquet （T2） and after removal of tourniquet （Ta） in 38 patients undergoing lower-extremity operation, The blood pressure, pulse and breath were also recorded. The effect of the tourniquet during the operation was evaluated. Results There were significant differences in hydrocortisone and glucagons among different time points（P〈0.01 for all）. The blood pressure, pulse and respiration showed some changes but no significant differences were found among the 4 time points （P〉0.05 for all）. The excellent hemostasticeffect was achieved in 100% of the patients. Conclusion Use of tour-niquet can raise the level of stress-related hormones and suitable pressure can reduce the stress reaction of patients.

关 键 词：下肢手术 止血带 压力 应激反应 护理 

分 类 号：R472[医药卫生—护理学]