超声引导下设置骨科下肢手术止血带压力值的应用效果探讨

Application effect of tourniquet pressure value in orthopedic lower limb surgery under ultrasound guidance

目的探究超声引导下设置骨科下肢手术止血带压力值的应用效果。方法选取2020年9月至2021年9月台州市第一人民医院骨科收治的150例下肢手术患者,采用随机数字表法分为对照组(n=74)和观察组(n=76)。对照组采用传统止血带止血,止血带压力在收缩压的基础上增加150mmHg(1mmHg=0.133kPa);观察组在超声技术观察腘动脉血流情况下,以腘动脉血流无显像为最佳止血带压力。比较两组患者止血效果、心率、压力值、疼痛程度和皮肤损伤等并发症情况。结果与对照组相比,观察组充气压力较低,差异有统计学意义(P<0.05);观察组放气前心率低于对照组,差异均有统计学意义(P<0.05);观察组止血带副损伤情况的发生例数及视觉模拟评分法(visual analogue scale,VAS)分数均低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率高于对照组,差异无统计学意义(P>0.05)。结论根据超声引导下设置骨科下肢手术中气压止血带压力值,可有效止血、阻断下肢动脉血流,为术中提供良好的手术视野,减少患者止血带相关副损伤的发生。

Objective To explore the application effect of setting the tourniquet pressure value in orthopedic lower extremity surgery guided by ultrasound.Methods A total of 150 patients admitted to the department of orthopedics of Taizhou First People's Hospital from September 2020 to September 2021 were selected and divided into control group(n=74)and observation group(n=76)according to random number table method.In the control group,the tourniquet pressure was increased by 150mmHg(1mmHg=0.133kPa)on top of the systolic pressure using the traditional method.In the observation group,the best tourniquet pressure was achieved with no visualisation of the popliteal artery blood flow under ultrasound technique.Compared the efficacy of haemostasis,heart rate,pressure values,pain levels and complications such as skin damage in the two groups.Results Compared with the control group,the inflation pressure in the observation group was lower,and the difference was statistically significant(P<0.05);the heart before deflation in the observation group was lower than that in the control group,and the difference was significant(P<0.05);the incidence of tourniquet side injury and the visual analogue scale(VAS)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);the overall complication rate of the observation group was higher than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion The pressure value of pneumatic tourniquet in orthopedic lower limb surgery under the guidance of ultrasound can effectively stop bleeding and block the blood flow of lower limb arteries,provide a good surgical field during surgery,and reduce the occurrence of tourniquet related side injuries in patients.