两种止血带缚扎压力的应用效果评价

Application Research of Two Tourniquet Pressures

目的比较依据肢体动脉阻断压和传统压力缚扎止血带的应用效果,为确立较安全、有效的止血带缚扎压力提供依据。方法对7例健康志愿者进行自身对照,采用肢体动脉阻断压力和传统压力两种方法缚扎止血带于受试者左下肢大腿根部,观察其左足第1趾甲襞微循环、肢体远端组织血流量和皮温的变化,并通过视觉模拟评分(visual analogue scales,VAS)评价受试者的主观感受。结果两种方法缚扎止血带时左足第1趾甲襞微循环血流均为停滞状态,肢体远端组织血流量比较差异无统计学意义(P>0.05);应用肢体动脉阻断压力时的肢体远端皮温高于应用传统压力时,而VAS评分低于应用传统压力时,差异有统计学差异(均P<0.05)。结论依据肢体动脉阻断压和传统压力缚扎止血带均能有效阻断血流,但依据肢体动脉阻断压确定的止血带压力缚扎止血带时受试者的肢体远端皮温降低幅度较小,肢体疼痛程度和不适度较低,故依据肢体动脉阻断压确定止血带压力是较为安全、有效的止血带使用压力,且能够减轻患者的肢体疼痛和不适感。

Objective To compare the clinical hemostatic effects of the tourniquet pressure set on the basis of limb occlusion pressure and the routine pressure,so as to provide a basis for establishing a safe and ef- fective tourniquet pressure. Methods Self-control designs were used. Tourniquets were tied at the root of left foot of 7 health volunteers,and then the tourniquet pressure set on the basis of limb occlusion pressure and the routine pressure were application to the ends of the left lower extremities. Observations were con ducted on the changes of the microcirculation, tissue blood perfusion, skin temperature of the distal limb of the first nail folds of the left feet. Visual analogue scales （VAS） was used to evaluate the subjective feeling of volunteers. Results The microcirculation was stopped in the first nail folds of the left foot at limb occlusion pressure level and traditional pressure level. There was no statistical difference in the tissue blood perfusion at the two levels（P〉0.05）. There was significant statistical difference in the skin temper- ature when the skin temperature of limb occlusion pressure level was higher than that of the routine pressure level. There was significant statistical difference in the VAS when the VAS of limb occlusion pressure level was lower than the traditional pressure level（P〈0.05）. Conclusion Tourniquet pressure set on the basis of limb occlusion pressure and the routine pressure can both block the blood flow. The decreased degree of skin temperature, the pain degree of extremities and the discomfort feeling were lower by tourniquet pressure set on the basis of limb occlusion pressure. Therefore, it provides a safe and effective tourniquet pressure to relieve pain and discomfort of the lower extremities of patients.