摘要
目的 探讨在下肢坏疽肢体截肢手术中使用止血带的有效性和安全性.方法 回顾性分析2009年1月至2023年6月北京博爱医院因下肢坏疽接受截肢的41例患者共44个肢体,根据手术中是否使用止血带分为非止血带组(n=28)和止血带组(n=16),比较两组手术野清晰度、手术出血量、切口愈合、术后30 d内再手术率、术中血压及心率、手术时间.结果 止血带组手术野更清晰(χ2=42.385,P＜0.001),手术出血量更少(Z=-2.082,P＜0.05).应用止血带的肢体均未出现止血带相关损害,如神经损伤和局部皮肤损伤.两组切口愈合甲级愈合率无显著性差异(χ2=0.028,P=0.624).结论 下肢坏疽肢体截肢时应用止血带可以提高手术野清晰度,减少手术中出血,不影响切口愈合.
Abstract
Objective To explore the efficacy and safety of using a tourniquet in amputation for lower limb gangrene.Methods All patients underwent amputation for lower limb gangrene from January,2009 to June,2023 in Beijing Bo'ai Hospital were reviewed,involving 41 patients with a total of 44 limbs,and they were divided into non-tourniquet group(n=28)and tourniquet group(n=16)according to whether a tourniquet was used during surgery.The am-putation field clearness,surgical bleeding,incision healing,reoperation rate within 30 days post-operation,intra-operative blood pressure and heart rate,and operation time were compared.Results The amputation field was clearer in the tourniquet group(χ2=42.385,P＜0.001),with less bleeding(Z=-2.082,P＜0.05).No tourniquet-related local damages,such as nerve damage and skin injuries,was observed in the limbs using tourniquets.The incidence of grade A of incision healing was not significantly different(χ2=0.028,P=0.624).Conclusion Application of tourniquet can improve the amputation field clearness and reduce bleeding during amputation for lower limb gangrene,without affecting incision healing.
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