Research on Individualized pressure of pneumatic tourniquet in pediatric patients' upper extremity under the ultrasound guidance
超声引导下设定幼儿上肢气压止血带个体化压力的研究

摘要

目的 探讨超声技术下幼儿上肢气压止血带个体化压力的设定。方法 2019年2月~2020年2月在我院行上肢开放性创伤手术并使用气压止血带的幼儿患者60例，随机分成试验组和对照组各30例。试验组利用超声技术设定止血带的个体化压力，对照组采用2019年版《手术室护理实践指南》推荐压力。比较两组止血带压力值，评价两组止血带止血效果，记录两组皮肤损伤情况。结果 两组幼儿止血带使用时间、血压、止血效果差异无统计学意义（P＞0.05）；试验组充气压力[（118.30±6.98）mmHg]明显低于对照组[（130.93±6.52）mmHg]，P＜0.05；试验组皮肤损伤程度总体轻于对照组（P＜0.05）；试验组皮肤损伤发生率（16.7%）明显低于对照组（46.7%），P＜0.05。结论 利用超声技术设定幼儿上肢手术止血带个体化压力的方法能够为临床幼儿上肢手术提供更小、更可行的止血带压力值，减少止血带相关并发症的发生，具有很好的研究、应用、临床推广前景。

Abstract

Objective To research the personalized tourniquet pressure settings under the ultrasonic techniques on the pediatric patients’ upper limb occlusion pressure. Method 60 cases of pediatric patients were admitted to our hospital to have surgery due to a severe upper extremity injury with the utilization of tourniquet pressure from February 2019 to February 2020. They were randomly divided into experimental group and control group with 30 cases respectively. In the experimental group, personalized tourniquet pressure was determined through the ultrasonic techniques, whereas in the control group, the recommended pressure was used according to the “Theater Nursing Practice Guideline, 2019 version”. The personalized tourniquet pressure value in both groups was compared and the effectiveness of tourniquet was evaluated, any skin injury was documented in both groups.
Results There was no significant difference (p >0.05) in the length of tourniquet use, tourniquet pressure and the effectiveness of tourniquet in both pediatric patients’ groups. However, the tourniquet pressure was found to be significantly lower in the experimental group[(118.30±6.98) mmHg] than the control group[(130.93±6.52)mmHg],P＜0.05.The degree of skin injury in the experimental group was less severe compared to the control group (P<0.05).The incident of skin injury was also significantly reduced in the experimental group(16.7%) compared to the control group(46.7%),p＜0.05.
Conclusion  The adoption of the personalized tourniquet pressure settings under the ultrasonic techniques on the pediatric patients’ upper limb occlusion pressure could provide a smaller and safer tourniquet pressure value in pediatric upper limb surgery in future clinical settings; and to reduce the incident of the tourniquet complications. This method has a good prospect in clinical application, and it should be recommended for clinical use.