气压止血带在下肢手术中的应用

Application of pneumatic tourniquet in lower limb surgeries

骨折、神经血管损伤、韧带撕裂等下肢创伤在生产生活中较为常见,现如今我国每年需行手术治疗的骨科创伤患者数量仍居高不下。气压止血带在下肢手术中有减少失血、改善术野清晰度和缩短手术时间等优点,应用广泛。目前临床上止血带的使用依旧较为“死板”,外科医师常根据个人经验进行设置,尚无统一的国家标准。然而止血带也有诸多弊端,压力设置不当将会造成一系列副损伤,对患者术后康复造成不利影响。副损伤的发生机制、更优的止血带使用策略、更个性化的压力设置是未来止血带应用的研究重点。本文总结近年来止血带的临床研究证据,探讨止血带在下肢手术中的利弊、使用策略及其个性化设置,以期为止血带的合理使用提供理论依据。

Lower limb traumas such as fractures,neurovascular injuries,ligament tears are not uncommon in clinical practice.Nowadays,surgical management among orthopedic trauma patients maintains a high need in China.Pneumatic tourniquet has the advantages of reducing blood loss,clarifying the operative field and shortening the operation time,and thus being widely used in lower extremity surgeries.But until now,there is no unified national standard for its clinical use,and surgeons often set related parameters based on their own experience.The tourniquet also has many disadvantages.Improper pressure setting can cause a series of side injuries,which may adversely affect the postoperative rehabilitation of patients.Further studies should focus on the mechanism of side injuries,better tourniquet application strategies,and more individualized pressure settings.This article summarizes the clinical research evidence for tourniquet use in recent years,discusses the pros and cons of tourniquet use in lower extremity surgeries,better application strategies and individualized settings,in order to provide a theoretical basis for more rational use of tourniquets.