“血管内止血带”临时阻断血流辅助手术治疗外伤性颈部及邻近躯干部位动脉损伤出血

Temporary occlusion of blood flow with intravascular tourniquet for treatment of traumatic neck and adjacent trunk artery hemorrhage

目的探讨术中应用“血管内止血带”（即球囊导管暂时阻断动脉腔内血流）临时阻断动脉腔内血流控制颈部及邻近躯干部位动脉损伤出血的可行性及临床意义。方法选择1987年5月-2009年2月收治的35例颈部及邻近躯干部位动脉损伤患者，术中先用“血管内止血带”临时阻断近端大动脉血流，每次阻断30-70min或间隔15-20min再阻断，行手术治疗。结果临时阻断近端大动脉血流后，术区出血极少，术野干净，解剖清晰，全部患者手术过程中出血量为100-400ml。所有患者均治愈。随访3-14年，无脑缺血、肢体缺血或病变复发。结论应用“血管内止血带”临时阻断近端大动脉血流可有效减少术中出血，提高手术的安全性，是治疗外伤性颈部及邻近躯干部位动脉损伤出血的非常可靠的辅助措施。

Objective To study the feasibility and clinical significance of internal tourniquet （temporary arterial lumen blood flow occlusion by balloon catheter） for controlling the hemorrhage from traumatic neck and adjacent trunk arteries by temporarily occluding the arterial lumen blood flow. Methods The study involved 35 patients with traumatic neck and near trunk arteries who were firstly managed by internal tourniquet during operation to temporarily occlude the proximal aorta blood flow from May 1987 to February 2009. Each blocking time ranged from 30 to 70 minutes and the blocking was per- formed at an interval of 15 to 20 minutes. Then, surgical therapy was taken. Results After temporary proximal aorta blood flow occlusion with internal tourniquet, the operation presented few bleeding, with a clean operating field and clear anatomic structures. The total intraoperative blood loss was 100-400 ml. All patients were healed without ischemia of brains and limbs or relapse during the 3-14 years of follow- up. Conclusion Internal tourniquet, which can effectively reduce intraoperative blood loss and im- prove operation safety by temporarily occluding the proximal aorta blood flow, is an auxiliary approach for treating hemorrhage from traumatic neck and adjacent trunk arteries.