2种常用战术战伤救治止血带对人体四肢止血效果的比较及分析

Comparison and analysis of the hemostatic effects on human limbs of the 2 common tactical tourniquets used in tactical combat casualty care

目的比较2种常用战术战伤救治止血带(卡式止血带及旋压式止血带)对人体四肢止血的效果,并探讨造成差异的原因。方法某基层连队30名军人,均为男性,平均年龄20.8岁。在四肢相应部位先后使用2种止血带施加最大止血压力进行固定。每次固定后,使用彩色多普勒血流显影技术(colorDopplerflowimaging,CDFI)观察桡动脉及足背动脉血流。使用血压计球囊测量2种止血带压力极值。结果旋压式止血带总有效率(97.5%)高于卡式止血带(17.5%),差异有统计学意义(P<0.05)。卡式止血带上肢止血有效率(35%)高于下肢(0%),差异有统计学意义(P<0.05)。卡式止血带压力极值为(134.08±21.39)mmHg,旋压式止血带压力极值为(247.47±29.21)mmHg,差异有统计学意义(P<0.05)。结论旋压式止血带的止血效果良好,值得推广。2种止血带止血有效率的差异可能与自身压力极值有关。

Objective To compare the hemostatic effects of the 2 common tourniquets(the cargo⁃strap tourniquet and the windlass tourniquet)used in tactical combat casualty care(TCCC)on limbs and also to investigate reasons for the differences.Meth⁃ods Two types of tourniquets were fixed successively on the corresponding sites of the limbs in 30 military personnel(all male,with an an average age of 20.8 years)to exert maximum hemostatic pressure.After each fixation,color Doppler flow imaging(CDFI)was performed to observe the blood flow of corresponding arteries(radial artery and dorsal foot artery).Then,the sphygmomanometer bal⁃loon was used to measure extreme pressure of the two tourniquets.Results The total effective rate of the windlass tourniquet(97.5%)was higher than that of the cargo⁃strap tourniquet(17.5%),with statistical significance(P<0.05).The effective rate of the cargo⁃strap tourniquet in the upper limbs(35%)was higher than that in the lower limbs(0%),with statistical significance(P<0.05).The extreme pressure of the cargo⁃strap tourniquet was(134.08±21.39)mmHg,while that of the windlass tourniquet was(247.47±29.21)mmHg,with statistical significance(P<0.05).Conclusion The windlass tourniquet has better effect and is worth further promotion.The dif⁃ference in hemostatic effectiveness between the two tourniquets might be related to their pressure extremes.