Mu Jinyan, Liu Dan, Ji Daihong, Li Borui, Li Zhigang, Zhang Feng, Lineaweaver William C
Ann Plast Surg. 2018 Mar;80(3):290-292. doi: 10.1097/SAP.0000000000001247.
The aim of this study was to investigate the clinical effect of tourniquet inflation pressure setting by ultrasonic Doppler on lower limb operation.
Ninety-six patients with total knee arthroplasty were selected in this study from January 2015 to December 2015. The patients were randomly divided into the study group and the control group with 48 cases in each group. In the control group, the tourniquet pressure is determined by the doctor's request for the patient's condition, but all the tourniquet pressure values should be 80 KPa or less. In the study group, ultrasonic Doppler was used to monitor the popliteal artery blood flow of surgery limb with the maximum systolic velocity in artery as a reference value. The pressure of pneumatic tourniquet gradually increased until the maximum systolic velocity was reduced to 0. At this time, the popliteal artery blood flow was not present. The 2 groups of patients with lower extremity tourniquet pressure, hemostatic effect of intraoperative tourniquet, and the incidence of adverse reaction using tourniquets were observed and recorded.
In the study group, the lower extremity tourniquet pressure and the incidence of adverse reaction using tourniquets were all better than that in control group; the difference between 2 groups was significant (P < 0.05). There was no significant difference between the 2 groups in the effect of hemostasis and the time of tourniquet operation (P > 0.05).
The method of ultrasonic Doppler setting lower extremity tourniquet pressure during the operation could not only ensure the hemostatic effect, but it could also provide the optimum individual pneumatic tourniquet pressure value for patients. In the meanwhile, it could reduce the incidence of adverse reaction using tourniquets effectively as well as improve the safety of the tourniquet. This method played an important role in the recovery of patients.
本研究旨在探讨超声多普勒设定止血带充气压力在下肢手术中的临床效果。
选取2015年1月至2015年12月行全膝关节置换术的96例患者，随机分为研究组和对照组，每组48例。对照组根据医生对患者病情的要求确定止血带压力，但所有止血带压力值应在80kPa及以下。研究组采用超声多普勒监测手术肢体腘动脉血流，以动脉收缩期最大流速作为参考值，逐渐增加气压止血带压力直至收缩期最大流速降至0，此时腘动脉血流消失。观察并记录两组患者下肢止血带压力、术中止血带止血效果及使用止血带不良反应的发生率。
研究组下肢止血带压力及使用止血带不良反应发生率均优于对照组，两组差异有统计学意义（P<0.05）。两组止血效果及止血带使用时间比较，差异无统计学意义（P>0.05）。
术中应用超声多普勒设定下肢止血带压力的方法，既能保证止血效果，又能为患者提供最佳的个体化气压止血带压力值，同时能有效降低使用止血带不良反应的发生率，提高止血带使用安全性，对患者康复具有重要作用。
