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骨科手术中止血带的注意事项

  骨科手术中止血带的注意事项
  Notes on tourniquet in orthopedic surgery
  使用止血带前,认真检查有否漏气,止血仪是否灵活实用,否则要及时更换。
  Before using tourniquet, carefully check whether there is air leakage and whether the hemostatic instrument is flexible and practical, otherwise, it should be replaced in time.
  按肢体及年龄,准确选用止血带(大、中、小号)。
  According to the limb and age, choose tourniquet (large, medium and small)。
  捆扎时松紧要适宜,以能容纳一指为宜。
  When strapping, the tightness should be appropriate to accommodate one finger.
  捆扎止血带前先用纱布或无菌巾缠绕保护肢体,并使其铺平,防止受力不均匀,而引起水泡或瘀血发生。
  Before strapping tourniquet, first use gauze or aseptic towel to protect the limb and make it smooth to prevent blister or blood stasis caused by uneven force.
  捆扎后要用纱布绷带加固两周,防止涨开或脱滑。
  After strapping, gauze bandage should be used for reinforcement for two weeks to prevent swelling or slipping.
  无菌止血带可由洗手护士在手术台上协助主刀医生捆扎,确保适宜的松紧度。
  The sterile tourniquet can be tied by the hand washing nurse on the operating table to ensure the appropriate tightness.
  严格掌握止血带的使用时限,单肢体第1次使用不超过90min,第2次使用不超过60min,2次间隔为5——10min。
  The time limit of tourniquet use should be strictly controlled. The first use of tourniquet should not be more than 90 minutes for a single limb and 60 minutes for the second time. The interval between the two times should be 5-10 minutes.
  驱赶血液时,要均匀持续用力,驱血带环绕重叠大于或等于1/3,且由肢体远端向近端逐渐驱赶血液至止血带边缘,充气至所需KPA,以达到充分止血的目的
  When driving blood, it is necessary to exert force evenly and continuously. The overlapping of the driving belt is greater than or equal to 1 / 3. The blood is gradually driven from the distal end of the limb to the proximal end to the edge of tourniquet, and inflated to the required kPa, so as to achieve the purpose of sufficient hemostasis
  多个肢体同时使用止血带,放松时,要先放松一肢体,待血压平稳后,再放松另一肢体。每一肢体的使用时限60min。防止经脉缺血时间过长,肢体坏死及有效循环血量突然加快,使心脏负担加。
  Multiple limbs use tourniquet at the same time. When relaxing, one limb should be relaxed first, and then the other limb should be relaxed after the blood pressure is stable. Each limb was used for 60 minutes. To prevent excessive ischemia time of meridians, limb necrosis and sudden acceleration of effective circulation blood volume, thus increasing the burden on the heart.