驱血止血弹性束紧套环在下肢淋巴吸脂减容术中的临床应用  

Clinical application of narrow elastic disposable tourniquet in liposuction reduction for lower limb lymphedema

作　　者：高源 曲晓荣 郑鸿伟 沈文彬 郝昆 关雷[1] GAO Yuan;QU Xiaorong;ZHENG Hongwei;SHEN Wenbing;HAO Kun;GUAN Lei(Department of Anesthesiology,Affiliated Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Orthopedics,Second People’s Hospital,Rongcheng City,Shandong Province,Rongcheng 264309,China;Department of Lymph Surgery,Affiliated Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,北京100038 [2]山东省荣成市第二人民医院骨科,山东荣成264309 [3]首都医科大学附属北京世纪坛医院淋巴外科,北京100038

出　　处：《吉林大学学报（医学版）》2024年第3期791-796,共6页Journal of Jilin University：Medicine Edition

基　　金：北京市科委首都特色研究项目(Z161100000516158)。

摘　　要：目的:分析驱血止血弹性束紧套环在下肢淋巴水肿吸脂减容术中的应用效果,为其临床应用提供依据。方法:回顾性分析309例行下肢淋巴水肿吸脂减容术患者的临床资料,分为未使用驱血止血弹性束紧套环组(n=163)和使用驱血止血弹性束紧套环组(n=146)。比较2组患者术中出血量、异体输血率、膨胀液入血相关不良反应发生率和血压波动发生率及术前与术后24 h血红蛋白(Hb)和白蛋白(Alb)水平。结果:与未使用驱血止血弹性束紧套环组比较,使用驱血止血弹性束紧套环组患者术中出血量、异体输血率和膨胀液入血相关不良反应发生率均降低(P<0.05或P<0.01),术中血压波动发生率升高(P<0.05)。与未使用驱血止血弹性束紧套环组比较,使用驱血止血弹性束紧套环组患者ΔHb水平(术前Hb水平-术后24 h Hb水平)和ΔAlb水平(术前Alb水平-术后24 h Alb水平)均降低(P<0.05或P<0.01)。结论:驱血止血弹性束紧套环应用于下肢淋巴水肿吸脂减容术可有效减少术中出血和异体输血,降低ΔAlb水平,防止膨胀液入血相关不良反应的发生,同时应注意其引起的术中循环波动等不良反应。Objective:To analyze the application effect of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema,and to provide the basis for its clinical application.Methods:The retrospective analysis was conducted on the clinical data of 309 patients who underwent liposuction reduction surgery for the lower extremity lymphedema.The patients were divided into non-narrow elastic disposable tourniquet group(n=163) and narrow elastic disposable tourniquet group(n=146).The intraoperative blood loss,rates of allogenic blood transfusion,incidence of adverse reactions related to dilation fluid into blood,incidence of blood pressure fluctuations,and preoperative and postoperative 24 h levels of hemoglobin(Hb) and albumin(Alb) of the patients in two groups were compared.Results:Compared with non-narrow elastic disposable tourniquet group,the intraoperative blood loss,allogenic blood transfusion rate,and incidence of adverse reactions related to dilation fluid into blood of the patients in narrow elastic disposable tourniquet group were decreased(P<0.05),while the incidence of intraoperative blood pressure fluctuations was increased(P<0.05).Compared with non-narrow elastic disposable tourniquet group,the ΔHb level(preoperative Hb levelpostoperative 24 h Hb level) and ΔAlb level(preoperative Alb level-postoperative 24 h Alb level) of the patients in narrow elastic disposable tourniquet group were decreased(P<0.05 or P<0.01).Conclusion:The application of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema can effectively reduce the intraoperative bleeding and the need for allogenic transfusions,decrease the level of ΔAlb,and prevent the occurrence of adverse reactions related to dilation fluid into blood.However,attention should be given to the potential adverse reactions related to intraoperative circulatory fluctuations.

关 键 词：驱血止血弹性束紧套环 淋巴水肿 吸脂减容术 不良反应 术中出血 

分 类 号：R618[医药卫生—外科学]