Paul S, Debien B
Département d'anesthésie et réanimation, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92141 Clamart, France.
Département d'anesthésie et réanimation, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92141 Clamart, France.
Ann Fr Anesth Reanim. 2014 Apr;33(4):248-55. doi: 10.1016/j.annfar.2013.12.021. Epub 2014 Feb 25.
The purpose of this literature review is, after a history and a point about current situation, to present the military use and precautions of use of tourniquet for civil and military medicine.
A review of the Anglo-Saxon and French literature was performed in PUBMED database, from 1962 to 2012. The research was conducted using the following keywords: "tourniquet", "complications", "haemorrhage", "emergency", "military medicine", used alone or in combination.
The extracted data concerned the history, the epidemiology, the interest of tourniquet during peacetime and wartime, adverse effects and the ratio benefit/risk.
The tourniquet is "a device which is tightened, in case of haemorrhage, around a limb in order to slow or stop the venous or arterial circulation before surgery…". This item is thus used in surgery to reduce intraoperative bleeding and in emergency medicine as a rescue technique for bleeding places non accessible to compression or to other technical hemostasis. It is also used for treating bleeding of mass casualties. However, its use is too poorly managed by health professionals and it remains risky. Recent armed conflicts have yet revived its day use.
The tourniquet has utility in times of war and in peacetime. In each case, indications and complications must be known.
本综述的目的是在介绍止血带的历史和现状后,阐述其在民用和军事医学中的军事用途及使用注意事项。
于2012年在PUBMED数据库中对1962年至2012年期间的盎格鲁 - 撒克逊语和法语文献进行了综述。研究使用了以下关键词:“止血带”、“并发症”、“出血”、“紧急情况”、“军事医学”,单独使用或组合使用。
提取的数据涉及止血带的历史、流行病学、在和平时期和战争时期的作用、不良反应以及效益/风险比。
止血带是“在出血情况下,环绕肢体收紧以在手术前减缓或阻止静脉或动脉循环的一种装置……”。因此,该物品用于手术中减少术中出血,并在急诊医学中作为对无法压迫或采用其他技术止血的出血部位的一种急救技术。它也用于治疗大批伤亡人员的出血。然而,卫生专业人员对其使用管理不善,且其使用仍存在风险。最近的武装冲突使它的日常使用再度兴起。
止血带在战时和平时均有作用。在每种情况下,都必须了解其适应证和并发症。