Lahl W, Lehmann M, Kurth M, Hofman B
Gefässchirurgische Abteilung, St. Willehad Hospital Wilhelmshaven.
Zentralbl Chir. 2003 Feb;128(2):144-8; discussion 148-9. doi: 10.1055/s-2003-37787.
The systemic effects of the pneumatic tourniquet technique in varicose vein surgery were studied in order to evaluate possible risks and threats.
155 patients were included to look at intraoperative changes of cardiovascular parameters and capillary blood and respiratory gases.
Whereas the pulse rate showed only an insignificant rise of 3/min, the systolic and diastolic blood pressure increased significantly by 12 and 6 mm Hg resp., after inducing ischemia by roller cuff. After removal of the roller cuff blood pressure decreased by 14 and 9 mm Hg, resp., again. At releasing of the ischemia, pH values drop by 0.02, and the base excess by 0.3 mval/L with operation on one side and 0.5 mval/L in both sides operation. In comparison, the capillary pCO 2 rose by 3 mm Hg and the pCO 2 of the respiratory air by 1 mm Hg in one side operation and 3 mm Hg, resp. in operation of both sides. The pressure in the roller cuff was in the middle only 55 mm Hg above systemic pressure values.
The systemic effects of the tourniquet technique have no clinical relevance. The use of the pneumatic tourniquet (Loefqvist method) is unrestrictedly recommended due to its advantages, such as no intraoperative blood loss, avoidance of post-op haematoma and pain and good immediate cosmetic results.
研究气动止血带技术在静脉曲张手术中的全身影响，以评估可能的风险和威胁。
纳入155例患者，观察心血管参数、毛细血管血和呼吸气体的术中变化。
使用袖带诱导缺血后，脉搏率仅出现无显著意义的每分钟3次升高，而收缩压和舒张压分别显著升高12 mmHg和6 mmHg。移除袖带后，血压再次分别下降14 mmHg和9 mmHg。解除缺血时，单侧手术pH值下降0.02，碱剩余下降0.3 mval/L；双侧手术时碱剩余下降0.5 mval/L。相比之下，单侧手术时毛细血管pCO₂升高3 mmHg，呼吸空气pCO₂升高1 mmHg；双侧手术时呼吸空气pCO₂分别升高3 mmHg。袖带压力仅比全身压力值高55 mmHg。
止血带技术的全身影响无临床相关性。由于气动止血带（勒夫奎斯特法）具有术中无失血、避免术后血肿和疼痛以及即时美容效果良好等优点，因此无限制推荐使用。
