血管内止血带的研制及临床应用  

The invention of internal tourniquet and its experimental studies and clinical use

作　　者：贺道华[1] 马廉亭[2] 张新元[2] 杨铭[2] 郑玉明[3] 陈庄洪[3] 潘力[2] 

机构地区：[1]南方医科大学研究生学院,广州510515 [2]广州军区武汉总医院神经外科 [3]广州军区武汉总医院骨科

出　　处：《中华实验外科杂志》2012年第3期466-468,共3页Chinese Journal of Experimental Surgery

基　　金：广州军区总后勤部卫生部2010年度临床高新技术重大项目（2010gxjs034）

摘　　要：目的研制一种自制的血管内止血带（过去曾用球囊导管代替），探讨血管内止血带的止血的效果及其安全性。方法将我们设计的血管内止血带置入大白兔右侧颈总动脉充盈球囊以阻断动脉腔内血流，随机将32只大白兔分为A组（阻断1h）和B组（阻断2h），采用测定体外和动脉腔内球囊内压力并通过肉眼及组织学动态观察其对管壁的影响；回顾总结过去临床采用血管内止血带救治邻近颈部及躯干动脉损伤34例。结果经病理检查，血管内止血带对动脉内膜与中层影响主要表现为炎性水肿与炎性细胞浸润，阻断1h组在14d内恢复正常；2h组，对管壁影响明显，部分内弹力膜拉直与断裂，21d才能恢复。阻断时间越长，对管壁影响越大；34例均应用血管内止血带止血成功，止血效果好，无缺血和血栓形成等并发症。结论血管内止血带是抢救邻近颈部及躯干大血管损伤及其晚期并发症假性动脉瘤与动静脉瘘手术的一种安全有效的辅助止血措施。Objective To study the efective and reliability of a self-made internal tourniquet （transarterial blood flow occlusion）by its experimental studies and clinical use in the treatment of arterial lesions to the trunk. Methods Internal tourniquet filling with liquid, were put into the right commom ca- rotid artery of 32 rabbits who divided into A Group and B Group, which was blocking up for 1 hour and 2 hours respectively. 34 cases of arterial injuries near trunk were treated by repair of the blood vessel after temporary occlusion of blood flow with internal tourniquet. Results Slight changes of the arterial wall which were proved to be positive correlated with length of the time occlusion of blood flow with internal tour- niquet, and the recovery of the structure appeared in 14 to 21 days postoperatively. No relapse and ische- mia of brain and limbs appeared among the patients being cured. Conclusion In the treatment of the arte- rial injuries closed to the trunk, internal tourniquet combined with operation is a safe, efective and recommendable therapeutic method, and internal tourniquet is a trustworthy auxiliary method to direct operation.

关 键 词：血管内止血带 动脉损伤 假性动脉瘤 动静脉瘘 手术 

分 类 号：R3[医药卫生—基础医学]