气压止血带在全膝关节置换术中应用的研究进展

Research Progress on the Application of Pneumatic Tourniquet in Total Knee Arthroplasty

随着全膝关节置换术(total knee arthroplasty, TKA)的不断成熟,术中如何使用气压止血带(简称止血带)已成为一个有争议的话题。使用止血带有几个好处,包括改善术野、减少术中失血和缩短手术时间等。相反,使用止血带也有几个明显的缺点,包括术后疼痛、神经肌肉损伤、缺血再灌注损伤及血栓形成的风险增加等对患者康复有负面影响。因此包括麻醉医师在内的医疗团队应该对其应用有正确的认识。近年来关于止血带在TKA中应用的研究报道逐渐增多,本文通过分析、总结止血带在TKA方面相关国内、外文献来对此做一综述。

With the continuous maturity of total knee arthroplasty (TKA), how to use pneumatic tourniquets (referred to as tourniquets) during surgery has become a controversial topic. The use of hemostasis has several benefits, including improving the surgical field, reducing intraoperative blood loss and shortening the operation time. On the contrary, the use of tourniquets also has several obvious disadvantages, including postoperative pain, neuromuscular damage, ischemia-reperfusion injury, and increased risk of thrombosis, which have negative effects on patient recovery. Therefore, the medical team including the anesthesiologist should have a correct understanding of its application. In recent years, research reports on the application of tourniquets in TKA have gradually increased. This article summarizes the domestic and foreign literature on tourniquets in TKA.