三种止血带动脉止血对犬束扎肢体静脉血气的影响  

Influence of arterial hemostasis with three tourniquets on venous blood gas in dogs

作　　者：王艳[1] 朱大乔[1] 王志红[1] 

机构地区：[1]第二军医大学护理学院,上海200433

出　　处：《中华创伤杂志》2010年第6期556-561,共6页Chinese Journal of Trauma

基　　金：军队＂十一五＂科技攻关课题资助项目（06 G61）

摘　　要：目的 通过动物实验观察三种止血带在控制犬下肢动脉出血时静脉血气指标的变化,分析并比较不同止血带对束扎侧组织的损伤程度.方法 将18只犬完全随机分为三组,并制作成后肢股动脉出血模型.采用橡皮管止血带、卡式止血带和多功能自控加压止血绷带（简称止血绷带）三种止血带对三组犬进行股动脉止血.分别测量三组犬止血带下压力并在止血后0.5,1,3,6 h检测束扎肢体静脉血气指标.结果 （1）止血绷带组的带下压力为0.74 kg,显著小于橡皮管止血带组（1.46 kg）和卡式止血带组（2.09 kg）（P＜0.05）.（2）止血后1 h,止血绷带组静脉血氧分压（PvO2）为（36.45±10.45）mm Hg,橡皮管止血带组为（28.73±9.07）mm Hg,均高于卡式止血带组的（21.87±4.30）mmHg（P＜0.05）;止血后3,6 h,止血绷带组二氧化碳分压（PvCO2）分别为（50.67±9.31）mm Hg和（60.02±10.85）mm Hg,橡皮管止血带组分别为（16.85±16.51）mmHg和（60.02±10.85）mm Hg,均低于卡式止血带组（P＜0.05或0.01）.结论 止血绷带在较小压力下能有效止住犬的股动脉出血;在三种止血带中,止血绷带对束侧组织的损伤最小.Objective To observe changes of venous blood gas when applying tourniquets to arterial bleeding dog models and compare the injury of the bundled tissues caused by three different tourniquets. Methods A total of 18 dogs were randomly divided to three groups and made into femoral artery bleeding model of the hind limbs. Then, rubber tubing, half-hitch tourniquet and multi-function pressure-control bandage （hemostatic bandage group） were employed respectively for femoral artery hemostasis in three groups. The pressure produced by the bandage and femoral vein blood gas indices were measured at 0.5, 1, 3 and 6 hours respectively after tourniquet application. Results The pressure produced by the hemostatic bandage group was 0.74 kg, which was obviously lower than 1.46 kg in the rubber tubing group and 2.09 kg in the half-hitch tourniquet group （ P 〈 0.05 ）. At one hour after hemostasis, PvO2 was （36.45 ± 10.45 ）mm Hg in the hemostatic bandage group and （28.73 ± 9.07 ）mm Hg in the rubber tubing group, which was significantly higher than （21.87 ±4.30） mm Hg in the half-hitch tourniquet group （ P 〈 0.05 ）. At 3 and 6 hours after hemostasis, PvCO2 was （50.67 ± 9.31 ） mm Hg and （60.02 ± 10.85）mm Hg respectively in the hemostatic bandage group, while （16.85 ± 16.51 ）mm Hg and （ 60.02 ± 10.85） mm Hg respectively in the rubber tubing group, which were lower than that in the half-hitch tourniquet group （ P 〈 0.05 or 0.01 ） . Conclusion Compared with rubber tubing and Halfhitch tourniquet, the hemostatic bandage can efficiently stop bleeding under slight pressure, with the least injury to the bundled tissues.

关 键 词：止血带 创伤和损伤 四肢 血气分析 

分 类 号：R472[医药卫生—护理学]