Foot Ankle Int. 2011 Mar;32(3):239-43. doi: 10.3113/FAI.2011.0239.
Limb occlusion pressure, which is present when blood flow ceases, has not had a practical method described for attainment. An automated tourniquet system was modified to set tourniquet pressure based on measurement of limb occlusion pressure (LOP). In this single surgeon randomized prospective study, the effectiveness of this system was assessed on patients undergoing foot and ankle surgery.
Two hundred forty-four patients were randomized to the study group of automated pressure (n = 112) or to the control group (n = 132). The primary outcome measure was tourniquet pressure used for either group. Secondary measures included the time to set the pressure and number of patients failing LOP measurement. The tourniquet field was assessed intraoperatively and postoperatively in a blinded manner.
The tourniquet pressure was significantly lower in the study group at 198.5 ± 20.2 mmHg compared to 259.6 ± 4.4 in the control group (p < 0.001). The time to measure the LOP was 20 ± 6 seconds. Six patients failed to be measured. The quality of the surgical field was judged to be better in the study group based on all three methods of assessment.
LOP measurement was a practical way of setting tourniquet pressures for limb surgery. The automated pressure averages were lower than those routinely used by most surgeons for thigh tourniquets.
当血流停止时会出现肢体闭塞压，但目前还没有一种实用的方法来获得这种压力。我们对自动止血带系统进行了改良，使其能够根据肢体闭塞压（LOP）的测量结果来设定止血带压力。在这项由单名外科医生进行的随机前瞻性研究中，我们评估了该系统在足部和踝关节手术患者中的效果。
244 名患者被随机分为自动压力组（n=112）或对照组（n=132）。主要观察指标为两组患者的止血带压力。次要观察指标包括设定压力的时间以及无法测量 LOP 的患者人数。术中及术后采用盲法对止血带区域进行评估。
研究组的止血带压力为 198.5±20.2mmHg，明显低于对照组的 259.6±4.4mmHg（p<0.001）。测量 LOP 的时间为 20±6 秒。有 6 名患者无法进行测量。根据三种评估方法，研究组的手术视野质量均被判定为更好。
LOP 测量是设定肢体手术止血带压力的一种实用方法。自动压力平均值低于大多数外科医生常规用于大腿止血带的压力。
