分子影像学杂志2025，Vol.48Issue(8)：978-983,6.DOI:10.12122/j.issn.1674-4500.2025.08.09
气压止血带在骨科手术中的临床应用效果与风险因素:一项前瞻性观察队列研究
Clinical efficacy and risk factors of pneumatic tourniquet in orthopedic limb surgery:a prospective observational cohort study
摘要
Abstract
Objective To investigate the clinical efficacy and risk factors of pneumatic tourniquet in orthopedic limb surgeries and analyze their effects and related influencing factors across different surgical subtypes(e.g.,trauma,arthroplasty,arthroscopy)in upper and lower limb procedures.Methods A prospective observational cohort study was conducted,enrolling 30 patients from Shenzhen People's Hospital from November to December 2024.Patients were stratified by surgical sites into an upper limb group(n=6;subtypes:5 trauma,1 arthroscopy)and a lower limb group(n=24;subtypes:13 arthroplasty,8 trauma,3 arthroscopy).Intraoperative blood loss,surgical field quality,postoperative physiological parameters(blood pressure,limb circumference,VAS pain score),laboratory markers(hemoglobin,D-dimer,C reactive protein),and neurological recovery were recorded.Results In the upper limb group,trauma surgery patients exhibited an 83.2%increase in postoperative D-dimer levels,significantly higher than the 78.9%increase in arthroscopy patients.In the lower limb group,arthroplasty patients demonstrated the largest D-dimer elevation(237%)and had lower postoperative VAS scores(3.0±1.0)compared to trauma patients(4.1±0.8,P=0.01).All neurological abnormalities resolved by postoperative day 3.Age was correlated with the amount of lower limb blood loss(r=0.32),while BMI was correlated with the changes in limb circumference(r=0.41,P<0.05).Conclusion Pneumatic tourniquets effectively optimize the surgical field in orthopedic procedures.Additionally,patient age showed a significant correlation with intraoperative blood loss and D-dimer increase in tourniquet-assisted surgeries,while BMI correlated significantly with changes in lower limb circumference,indicating that patients with larger limb circumferences may experience higher rates of postoperative limb swelling and neurological and limb sensory abnormalities compared to those with smaller limb dimensions.Therefore,enhanced monitoring and rehabilitation exercises are necessary after surgery.关键词
气压止血带/骨科手术/临床效果/风险因素/前瞻性观察队列Key words
pneumatic tourniquet/orthopedic surgery/clinical efficacy/risk factor/prospective observational cohort引用本文复制引用
蔡文进,刘遂玉,潘承通,陈欣,吕霞,刘弼..气压止血带在骨科手术中的临床应用效果与风险因素:一项前瞻性观察队列研究[J].分子影像学杂志,2025,48(8):978-983,6.基金项目
广东省医学科研基金(B2023167) （B2023167）
