卞群燕

【摘要】目的 观察肢体抬高驱血方法应用于骨科上肢手术中的驱血效果。方法 选择我院收治的60例骨科上肢手术，按驱血方式不同随机分为观察组和对照组两组，每组30例。观察组患者采用肢体抬高方法驱血，对照组患者采用驱血带驱血。所有患者均为一次止血带时间完成的无菌手术切口病例，使用相同型号止血带，压力高于病人收缩压100 mmHg。观察和比较术中出血量及术后并发症发生情况。结果 观察组患者术中出血量和术后并发症发生率均显著低于对照组，差异有统计学意义（P<0.05），即：观察组患者驱血效果显著优于对照组。结论 肢体抬高驱血法用于骨科上肢手术中，驱血效果满意，并发症发生率低，值得临床推广使用。

【关键词】骨科手术；驱血；驱血带；肢体抬高

【中图分类号】R658.2 【文献标识码】A 【文章编号】ISSN.2095-6681.2017.36..02

【Abstract】Objective To observe the effect of limb elevation blood flooding in the operation of upper limb of the Department of orthopedics.Methods 60 cases of upper limb surgery in Department of orthopedics were randomly divided into observation group and control group， with 30 cases in each group，and two groups were randomly divided into the control group and the observation group.The patients in the observation group were driven by the method of limb lift to drive blood， and the patients in the control group were displacing the blood by displacing the blood.The same type of tourniquet was used in all patients，with the same type of tourniquet，and the pressure was higher than the patient's systolic pressure of 100mmHg.The amount of bleeding and the incidence of postoperative complications were observed and compared.Results The bleeding volume and postoperative complication rate in the observation group were significantly lower than those in the control group， the difference was statistically significant （P<0.05）， that is： the blood drive effect in the observation group was significantly better than that in the control group.Conclusion Elevation of the limb exsanguination used in orthopedic surgery of upper extremity and drive blood with satisfactory effect， low incidence of complications， worthy of clinical use.

【Key words】Department of orthopedics operation； Blood flooding；Blood drive belt； Limb elevation

出血是骨科手術最常见的现象之一，手术前使用驱血带和（或）止血带具有术野清晰可见、解剖结构清楚、手术过程迅速，出血数量减少等优点，尤其是在四肢末端手术中更具价值。但由使用止血带和驱血带而造成的损害也屡见不鲜，相关研究报道[1-2]：在刚开始驱血和结束驱血过程中最容易发生急性肺栓塞，甚至导致死亡等严重并发症。驱血带局部引起的并发症很多，如：局部皮肤瘀血和水疱、浅表神经压迫致挫伤和肌肉疼痛不适、出血迅速加重而致一过性低血压等，在临床手术治疗实践中并不罕见。因此，在四肢骨折手术过程中应该慎用驱血带的建议还是比较可取的[3]；当然，对于某些需要使用的手术患者，我们对此必须引起足够的重视。临床上常用的驱血方法有多种，驱血效果及并发症的发生率情况报道不一。……