驱血止血弹性束紧套环在下肢淋巴吸脂减容术中的临床应用

Clinical application of narrow elastic disposable tourniquet in liposuction reduction for lower limb lymphedema

摘要

目的 分析驱血止血弹性束紧套环在下肢淋巴水肿吸脂减容术中的应用效果，为其临床应用提供依据。 方法 回顾性分析309例行下肢淋巴水肿吸脂减容术患者的临床资料，分为未使用驱血止血弹性束紧套环组（n=163）和使用驱血止血弹性束紧套环组（n=146）。比较2组患者术中出血量、异体输血率、膨胀液入血相关不良反应发生率和血压波动发生率及术前与术后24 h血红蛋白（Hb）和白蛋白（Alb）水平。 结果 与未使用驱血止血弹性束紧套环组比较，使用驱血止血弹性束紧套环组患者术中出血量、异体输血率和膨胀液入血相关不良反应发生率均降低（P<0.05或P<0.01），术中血压波动发生率升高（P<0.05）。与未使用驱血止血弹性束紧套环组比较，使用驱血止血弹性束紧套环组患者ΔHb水平（术前Hb水平-术后24 h Hb水平）和ΔAlb水平（术前Alb水平-术后24 h Alb水平）均降低（P<0.05或P<0.01）。 结论 驱血止血弹性束紧套环应用于下肢淋巴水肿吸脂减容术可有效减少术中出血和异体输血，降低ΔAlb水平，防止膨胀液入血相关不良反应的发生，同时应注意其引起的术中循环波动等不良反应。

Abstract

Objective To analyze the application effect of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema，and to provide the basis for its clinical application. Methods The retrospective analysis was conducted on the clinical data of 309 patients who underwent liposuction reduction surgery for the lower extremity lymphedema. The patients were divided into non-narrow elastic disposable tourniquet group （n=163） and narrow elastic disposable tourniquet group （n=146）. The intraoperative blood loss， rates of allogenic blood transfusion， incidence of adverse reactions related to dilation fluid into blood， incidence of blood pressure fluctuations， and preoperative and postoperative 24 h levels of hemoglobin （Hb） and albumin （Alb） of the patients in two groups were compared. Results Compared with non-narrow elastic disposable tourniquet group， the intraoperative blood loss， allogenic blood transfusion rate， and incidence of adverse reactions related to dilation fluid into blood of the patients in narrow elastic disposable tourniquet group were decreased （P<0.05）， while the incidence of intraoperative blood pressure fluctuations was increased （P<0.05）. Compared with non-narrow elastic disposable tourniquet group， the ΔHb level （preoperative Hb level-postoperative 24 h Hb level） and ΔAlb level（preoperative Alb level-postoperative 24 h Alb level） of the patients in narrow elastic disposable tourniquet group were decreased （P<0.05 or P<0.01）. Conclusion The application of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema can effectively reduce the intraoperative bleeding and the need for allogenic transfusions， decrease the level of ΔAlb， and prevent the occurrence of adverse reactions related to dilation fluid into blood. However， attention should be given to the potential adverse reactions related to intraoperative circulatory fluctuations.

关键词

驱血止血弹性束紧套环 / 淋巴水肿 / 吸脂减容术 / 不良反应 / 术中出血

Key words

Narrow elastic disposable tourniquet / Lymphedema / Liposuction reduction / Adverse reaction / Intraoperative bleeding

Author summay

高 源（1985-），女，河北省保定市人，主治医师，医学硕士，主要从事临床麻醉管理方面的研究。