驱血带用于下肢静脉曲张手术的有效性与安全性评价

Evaluation on efficacy and safety of blood-letting tape used in lower extremity varicose vein operation

目的探讨驱血带用于下肢静脉曲张手术的有效性及安全性。方法将该院收治的158例下肢静脉曲张患者作为研究对象,所有患者均行大隐静脉高位结扎联合点状抽剥术,其中117例在术中使用驱血带阻断下肢血流(观察组),41例未使用驱血带(对照组),观察两组患者的术中出血量、手术时间、疼痛程度、术后并发症等情况。结果与对照组比较,观察组的手术时间、术中出血量、血肿评分、凝血酶原时间(PT)和纤维蛋白原(FIB)明显降低(P<0.05),活化部分凝血活酶时间(APTT)和凝血酶时间(TT)明显升高(P<0.05)。观察组患者的下肢血流阻断时间为45~62min,平均(46.68±5.53)min。两组患者术后2周的感觉评分和疼痛评分比较均差异无统计学意义(P>0.05)。术后两组均未见动脉异常,患肢无明显缺血性损伤。结论在下肢静脉曲张手术中应用驱血带短暂性阻断血流,能够有效缩短手术时间,减少术中出血,降低皮下血肿形成风险,安全性高。

Objective To investigate the efficacy and safety of exsanguination band used in the lower extremity varicose vein operation. Methods A total of 158 cases of lower extremities varicose veins in this hospital served as the research subjects. All ca- ses underwent the high ligation of great saphenous vein combined with punctate stripping operation. Among them, 117 eases intrao- peratively used the exsanguination band for blocking the lower limb blood flow （observation group） ,41 cases did not use the exsan- guination band （control group）. Then the intraoperative bleeding volume, operation time, pain degree and postoperative complica- tions were observed in the two groups. Results Compared with the control group,the operation time,intraoperative blood Ioss,hematoma score,prothrombin time （PT） and fibrinogen （FIB） in the observation group were significantly decreased （P〈0.05） ,while activated partial thrombin time （APTT） and thrombin time （TT） were significantly increased（P〈0.05）： The lower limb blood flow occlusion time in the observation group was 45--62 rain with an average of （46.68zk5.53） min. The sensory score and pain score at postoperative 2 weeks had no statistical difference between the two groups （P〉0.05）. No arteriai abnormalities and no obvious ischemic injury were found i＇n the injured limbs of 2 groups. Conclusion Applying the exsanguination band for transiently blocking the blood flow can effectively shorten the operation time, reduces the intraoperative bleeding amount and decreases the sub- cutaneous hematoma formation risk with high safety.