Corbett R, Jayakumar K N
Cuckfield Hospital, Haywards Heath, Sussex.
Ann R Coll Surg Engl. 1989 Jan;71(1):57-8.
A controlled randomised trial has been carried out to ascertain if there are tangible benefits from using a tourniquet when avulsing varicose veins during routine varicose vein surgery. Twenty-six patients have been studied. Twenty limbs were operated on with a tourniquet and 20 limbs without a tourniquet. The mean weight of varices excised was 2.76 g (range 0.51-8.79 g) with a tourniquet and 2.68 g (0.77-11.27 g) without a tourniquet (NS, Wilcoxon's rank sum test). Mean blood loss was 16 ml (0-136 ml) with a tourniquet and 107 ml (16-581 ml) without a tourniquet (P less than 0.01, Wilcoxon's rank sum test). The mean time to complete avulsions was 38 min with a tourniquet and 35 min without a tourniquet (NS, Student's t test). The tangible benefits of a tourniquet are limited to the saving of blood which can amount to 500 ml per leg. Losses could amount to 1 litre in bilateral cases operated upon without tourniquet. The method is simple, provides a clean operating field and should be more widely used.
已开展一项对照随机试验，以确定在常规静脉曲张手术中剥脱静脉曲张时使用止血带是否有切实益处。研究了26例患者。20条肢体使用止血带进行手术，20条肢体未使用止血带。使用止血带时切除的静脉曲张平均重量为2.76克（范围0.51 - 8.79克），未使用止血带时为2.68克（0.77 - 11.27克）（无显著性差异，威尔科克森秩和检验）。使用止血带时平均失血量为16毫升（0 - 136毫升），未使用止血带时为107毫升（16 - 581毫升）（P小于0.01，威尔科克森秩和检验）。使用止血带时完成剥脱的平均时间为38分钟，未使用止血带时为35分钟（无显著性差异，学生t检验）。止血带的切实益处仅限于节省血液，每条腿可节省达500毫升。在未使用止血带进行双侧手术的情况下，失血量可能达1升。该方法简单，能提供清洁的手术视野，应更广泛地使用。
