Snyder S O
Edwards-Eve Clinic, Nashville, TN 37205, USA.
Semin Vasc Surg. 1997 Mar;10(1):31-3.
Pneumatic tourniquet techniques can facilitate numerous vascular surgical procedures by providing a bloodless surgical field and minimizing vessel wall trauma. Vessel dissection is simplified by requiring only a short segment of anterior vessel wall exposure, and trauma is avoided to the perianastomotic arterial branches and accompanying veins. Tourniquet use is particularly helpful for the distal anastomosis of infrapopliteal and pedal bypass procedures, but is also ideal for localized endarterectomy procedures. Correction of vein graft stenosis in upper extremity dialysis access procedures greatly facilitates removal of infected prosthetic grafts in the distal upper or lower extremity. The potential complications of nerve compression, ischemic skeletal muscle damage, and reperfusion problems associated with tourniquet use are not a clinical problem with the short occlusion times required for vascular procedures. The absence of clamps improves the anastomotic visualization and increases the mobility of the surgical site to aid surgical anastomotic techniques. The clinical use of pneumatic techniques among vascular surgeons continues to increase as surgeons become aware of its utility and expand its applications.
气压止血带技术可通过提供无血手术视野并将血管壁创伤降至最低，从而有助于开展众多血管外科手术。只需暴露一小段血管前壁即可简化血管解剖操作，同时可避免对吻合口周围动脉分支及伴行静脉造成创伤。止血带的使用对于腘动脉以下及足部旁路手术的远端吻合尤为有用，对于局限性动脉内膜切除术也十分理想。在进行上肢透析通路手术时，纠正静脉移植物狭窄极大地便于移除上肢或下肢远端的感染人工血管移植物。与使用止血带相关的神经受压、缺血性骨骼肌损伤和再灌注问题等潜在并发症，在血管手术所需的短时间阻断情况下并非临床问题。无需使用血管夹可改善吻合口视野，并增加手术部位的活动度，有助于手术吻合技术。随着血管外科医生逐渐意识到气压技术的实用性并扩大其应用范围，气压技术在临床中的使用持续增加。
