踝部止血带与大腿止血带在足部手术中的应用比较  

Comparison of the effect and the security between ankle tourniquet and thigh tourniquet

作　　者：宋达玮[1] 程宇[1] 倪莉[1] 孟斌[1] 张志刚[1] 张洪涛[1] 杨惠林[1] 

机构地区：[1]苏州大学附属第一医院,苏州215006

出　　处：《中国矫形外科杂志》2013年第17期1708-1712,共5页Orthopedic Journal of China

摘　　要：[目的]评价踝部止血带和大腿止血带在足部手术中的效果和安全性。[方法]回顾性研究选取本院行踝部以下手术的病例(2010年5月～2012年12月)共44例,其中,踝部止血带组21例,大腿止血带组23例。观察踝部止血带组和大腿止血带组的手术视野,术中血压、心率波动,止血带休克的变化,术后神经损伤,皮肤水泡等指标,对二者的应用效果和安全性进行比较分析。[结果]在足部手术中,二者均能提供一个良好的无血的手术视野,但术中使用踝部止血带相较大腿止血带所引起的术中血压波动及心率变化、术后神经症状和皮肤水泡发生率更低(P<0.05),止血带休克发生率差异无统计学意义(P>0.05)。[结论]二者在足部手术中均能提供一个清晰地手术视野,但踝部止血带相比于大腿止血带在足部手术中具有更高的安全性。[Objective]To evaluate the effect and the security of the application of ankle tourniquet and thigh tourniquet.[Methods]A retrospective study was carried out among 44 patients in our hospital（from May 2010 to December 2012） who received podiatric operations below the ankle level.Twenty-one of them received ankle tourniquet,and 23 of them received thigh tourniquet.We observed the operation area,fluctuation of blood pressure and heart rate before and after deflating the tourniquet and the occurence of the tourniquet shock to compare the effect and the security of the application of ankle tourniquet and thigh tourniquet.[Results]In podiatric surgery,both tourniquets could create a bloodless surgical area,while the fluctuation of blood pressure,heart rate,the occurrence of neurological symptoms and the skin damage rate were all less in ankle tourniquet group than in thigh tourniquet group（P＆lt;0.05）,but the difference in tourniquet shock rate was not obvious（P＆gt;0.05）.[Conclusion]Both tourniquets could create a bloodless surgical area,however,the application of ankle tourniquet is safer than thigh tourniquet in podiatric surgery.

关 键 词：踝部止血带 大腿止血带 止血带休克 血压 心率 

分 类 号：R658.3[医药卫生—外科学]