影响小儿四肢手术气压止血带压力的相关因素分析

目的探讨影响小儿四肢手术气压止血带压力的相关因素,为确立较为安全、有效的止血带压力提供依据。方法采用便利抽样的方法,选取2009年9月～2011年6月接受四肢手术的小儿患者122例,测量患儿肢体周长、收缩压,采用血氧监护仪监测肢体末梢血氧饱和度的方法来判断止血效果,并记录阻断肢体动脉血流的最低压力,分析性别、年龄、收缩压及周长对止血带压力的影响及关系。结果小儿止血带压力与收缩压、肢体周长、年龄呈正相关。用四肢周长预测气压止血带压力,与实际需要压力值最接近,上肢止血带压力与肢体周长的关系:Y=8.116+0.830 X2(Y=止血带压力;X2:肢体周长);下肢止血带压力与肢体周长的关系:Y=0.793+1.078 X2(Y=止血带压力;X2:肢体周长)。结论根据小儿四肢周长计算小儿四肢手术中充气止血带最低有效压力,与实际需要压力最接近,使止血带的使用符合个体生理,避免了盲目加压所致并发症的发生。此方法无创伤,操作简捷,不受条件限制,在各种医疗条件下均可使用。

Study for the relationship between some effect factors and pressure of pneumatic tourniquet on children limbs

Objective To study the related factors that affect hemostatic pressure in children limbs surgery and to determine a simple calculation method of hemostatic pressure. Methyl 122 children with limbs surgery in our hospi- tal from September 2009 to June 2011 was selected by convenient sampling. The limbs perimeter and systolic pres- sure were measured before surgery, the lowest pressure on blocking peripheral arterial blood flow, gender, age, systolic blood pressure and perimeter tourniquet pressure was recorded for studying their effect and relationship The hemostatic by blood oxygen monitor of the prison. Result A significant positive correlation was seen among tourni- quet pressure systolic blood pressure and limb circumference. The tourniquet pressure on the upper limb：Y=8. 116 -k0. 830X2; the tourniquet pressure on the lower limb ：Y= 0. 793 ＋1. 078X2 （Y2, The tourniquet pressure; X2 .. limb circumference）. Conclusion Minimum effective pressure estimation can be made by knowing limb circumference with no injury. Hemostasis with tourniquet was in keeping with individual physiology, which decreased complication. Hemostasis with tourniquet could be used in many medical treatment conditions in view of leading no injury, easy operation and being not limited by conditions,