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当前位置:手术中止血带的使用要点

止血带的正确使用 The correct use of a tourniquet 术前要对止血带进行仔细检查,如气囊是否漏气,打气筒是否好用,气压表是否准确。 The tourniquet should be carefully checked before operation, such as whether the air bag is leaking, whether the inflator is used properly, and whether the barometer is accurate. 根据患者年龄、肢体周径、病人体质等因素选用合适的气压止血带。放置止血带的部位应正确,止血带要绑于肢体肌肉较丰富部位,以防损伤神经。上肢者放在上臂中上1/3处,下肢者应放在大腿根近腹股沟部。 Suitable pneumatic tourniquet is selected according to factors such as age of patients, circumference of limbs, and constitution of patients. The location of tourniquet should be correct, tourniquet should be tied to the more abundant parts of the body muscles to prevent injury to the nerves. The upper extremities should be placed on the upper 1/3 of the upper arm, and the lower extremities should be placed near the groin portion of the thigh. 绑止血带时,止血带下要垫一个小单(布),并使接触皮肤面保持平整。止血带要绑的松紧适宜,通气管要放在肢体近端,即可防止污染手术野,又便于打气。气压止血带外最好再缠固定带或绷带加压固定,防止充气后滚动。 When tourniquet is tied, a small sheet (cloth) should be placed under the belt to keep the skin smooth. The tourniquet should be tighten up properly, and the ventilating tube should be placed near the extremities. It can prevent the contamination of the operating field and facilitate the inflation. Outside the pneumatic tourniquet, it is best to fix the belt or bandage to pressurize and prevent inflation. 止血带充气前应先抬高肢体,驱血带驱血彻底后,再将止血带的通气管接于压气表上,缓慢将气打入止血带内。上肢压力成人不超过40.0kPa(300mmHg),小儿不超过26.7kPa(200mmHg),下肢压力成人不超过80kPa(600mmHg),小儿不超过33.3kPa(250mmHg)。 Before the tourniquet is inflated, the limb should be raised first. After the blood drive is completely removed, the tourniquet tube is connected to the pressure gauge, and the gas is slowly pushed into the tourniquet. The upper limb stress is not more than 40.0kPa (300mmHg) in adults, and children do not exceed 26.7kPa (200mmHg). Lower extremity pressure is not more than 80kPa (600mmHg) in adults and no more than 33.3kPa (250mmHg) in children. 准确记录气压止血带充气时间,上肢以1h,下肢以1.5h为限,时间到时,需提前通知手术医生做好放气准备,如需继续使用,应先放气5~10min后再充气并重新记录时间。 Accurately record the air pressure tourniquet inflating time, the upper limb is 1H, the lower extremities are limited to 1.5h. When the time arrives, it is necessary to inform the surgeon in advance for the release of air. If you need to continue to use it, we should first inflate 5 to 10min and then inflate and record the time. 松止血带时,放气要缓慢,以免血压急剧下降引起休克。手术完毕去除止血带后,检查病人皮肤有无损伤,必要时局部按摩数分钟。 When the tourniquet is loosed, it is slow to deflate, so as to avoid a sharp drop in blood pressure and cause shock. After the operation is done, remove the tourniquet and check whether the patient's skin is damaged or not. If necessary, local massage for several minutes. 止血带的使用误区 The misuse of tourniquet 1 手术台上捆扎的误区 1 misunderstandings on the strapping on the operating table (1)肱骨及股骨中下段手术中,为减少出血,往往需要无菌止血带,由主刀医生在手术台上捆扎,因而致使止血带的松紧度没有保证,充气量也无法确定,造成出血,甚至出现皮肤坏死及神经麻痹等并发症; (1) in the operation of the humerus and the middle and lower part of the femur, a aseptic tourniquet is often needed to reduce bleeding, which is tied up by the surgeon on the operating table. Therefore, the tightness of the tourniquet has not been guaranteed, the volume of the aeration is also undetermined, causing bleeding, even skin necrosis and nerve paralysis. (2)驱赶血液时,驱血带每周圈间都留有大小不等的距离,形成间断驱血,效果极差; (2) when the blood is expelled, there is a distance between the blood strips every week, which leads to intermittent blood drive, and the effect is very poor. (3)驱血时用力不匀,一绕一缓,不能持续用力,止血效果差; (3) when the blood is disused, the force is not uniform. If the wound is slow, the force can not be sustained and the hemostatic effect is poor. (4)肱骨中段手术中,为减少出血,使用小儿无菌止血带止血,因气囊短而窄,达不到压迫止血的目的,反而出血更多。 (4) during the operation of the middle part of the humerus, in order to reduce bleeding, the use of aseptic tourniquet in children to stop bleeding because of the short and narrow airbag can not reach the aim of oppression and hemostasis, but more bleeding.