Fisher Brent, Roberts Craig S
Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA.
South Med J. 2010 Nov;103(11):1156-60. doi: 10.1097/SMJ.0b013e3181efaf3b.
The use of tourniquets for upper and lower extremity operative procedures is controversial in patients with sickle cell hemoglobinopathies. The authors used Ovid and MEDLINE®, PubMed, and CINAHL® to detect English-language reports of any surgical procedure where a tourniquet was used on a patient with sickle cell disease or trait. Four papers met the search criteria and were reviewed. These studies included 96 patients with hemoglobin SS, SC, and sickle cell trait (AS). The investigations differed in tourniquet type, perioperative care, operative procedure, and patient genotype distribution. Twelve of 96 sickle cell patients (12.5%) experienced postoperative complications (8 SS/SC and 4 AS) detailed in two of the four studies. Nonetheless, the available limited evidence suggests that with proper perioperative management and necessary precautions, tourniquets can be used with relative safety in most patients with sickle cell disease.
对于镰状细胞血红蛋白病患者，在上下肢手术中使用止血带存在争议。作者利用Ovid、MEDLINE®、PubMed和CINAHL®检索了关于对镰状细胞病或镰状细胞特征患者使用止血带的任何外科手术的英文报道。有四篇论文符合检索标准并进行了综述。这些研究纳入了96例血红蛋白SS型、SC型和镰状细胞特征（AS型）的患者。这些研究在止血带类型、围手术期护理、手术操作和患者基因型分布方面存在差异。96例镰状细胞患者中有12例（12.5%）出现了术后并发症（8例SS/SC型和4例AS型），这在四项研究中的两项中有详细描述。尽管如此，现有的有限证据表明，通过适当的围手术期管理和必要的预防措施，止血带在大多数镰状细胞病患者中使用相对安全。
