烧伤患者肢体削痂植皮手术中止血带的应用

The application of tourniquet in burn patients during tangential excision on the extremities

目的 探讨烧伤患者肢体削痂植皮手术中止血带的使用方法。方法 79例拟行肢体削痂植皮手术的烧伤患者随机分为两组 ,A组 (4 1例 )采取持续止血带控制下的削痂植皮 ;B组 (38例 )仅在削痂时使用止血带 ,植皮过程中不使用。观察手术过程中两组的手术失血量、输血量、手术时间和术后创面植皮成活率、有无并发症。 结果 A组手术失血量和输血量比B组分别减少 4 2 %和 5 0 % (P<0 .0 0 1) ,上、下肢手术时间与B组相比缩短了 4 1%和 37% (P <0 .0 0 1) ,两组植皮成活率和皮片下血肿发生率差异无显著性意义 (P >0 .0 5 )。 结论 采用持续止血带技术能有效地控制肢体削痂植皮手术中的失血 ,减少输血量 。

Objective To investigate the application of tourniquet in burn patients during tangential excision on the extremities. Methods Seventy-nine burn patients who were arranged to receive tangential excision and skin grafting on the extremities were randomly divided into A and B groups. The patients in A group (n=41) underwent the operation with the tourniquet applied continuously throughout the operation, while those in B group (n=38) ,only with tourniquet applied during tangential excision. The amounts of blood loss and blood transfusion, the operation time and the take rate of grafted skin and the incidence of complications were investigated and recorded. Results The amounts of blood loss and blood transfusion during operation in A group were 42% and 50% less than those in B group, respectively (P<0.001). Moreover, the operation time on the upper and lower extremities in A group was much shorter (for 41% and 37%, respectively) than those in B group (P<0.001). In addition, there was no difference of the take rate of skin graft and the incidence of subcutaneous hematoma between the two groups (P>0 05). Conclusion Continuous tourniquet application during tangential excision on the extremities in burn patients was proved to be effective in reducing operational blood loss, blood transfusion and in shortening operation time.[