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題名 | 氣壓式止血帶對血流動力學與動脈血液氣體分析及乳酸的影響 |
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作者姓名(中文) | 李繼源; | 書刊名 | 醫學研究 |
卷期 | 11:3 1990.11[民79.11] |
頁次 | 頁193-198 |
分類號 | 416.3 |
關鍵詞 | 氣壓式止血帶; 血流動力學; 動脈血液氣體; 乳酸; |
語文 | 中文(Chinese) |
中文摘要 | 氣壓式止血帶廣泛地應用在肢體手術,然而其安全性的限制仍未完全明朗化。本研究包括36位接受肢體手術的病人(ASA Ⅰ-Ⅱ)。A組乃接受上肢手術者有16位,B組則為接受下肢手術者有20位。所有病人都接受全身麻醉,手術中控制其呼吸,使動脈血液二氧化碳分壓(PaC□)維持在30毫米這柱。止血帶放鬆前及放鬆後第1,2,3,4,5分鐘,記錄血壓及心率,同時自動脈導管(A-line)抽血作酸鹼值,氣體分析及乳酸的測定。 兩組(A和B)病人的血壓在止血帶放鬆後,都有明顯下降約20毫米這柱,與放鬆前比較,統計上有意義(p<0.05)。心跳速率雖略為下降,但統計上無差異。B組病人在止血帶放鬆後,動脈血液酸鹼值下降,二氧化碳分壓上升,皆有統計上差異;乳酸值在第3,4,5分鐘,也是有意義增加(P<0.05)。A組病人動脈血液之酸鹼值,二氧化碳分壓及乳酸值,在止血帶放鬆前後,沒有明顯差異。 氣壓式止血帶對下肢手術的影響遠大於上肢手術。有潛在性顱內壓增加危險的病人,使用時應密切注意。對於影響血流動力學的代謝機轉,則有待進一步探討。 |
英文摘要 | Use of a tourniquet is routine practice in limb surgery yet the limits of safety have not been well defined. This investigation has been carried out on 36 patients (ASA Ⅰ-Ⅱ) undergoing upper limb (group A) or lower limb (group B) surgery. All patients received general anesthesia were ventilated mechanically and the PaC□ was maintained at approximately 30 mmHg during operation. Before and the first, second, third, fourth and fifth minutes after the tourniquet deflation, the bloods pressure and heart rate were recorded; arterial blood was drawn from A-line to detect the lactate level and gas analysis (pH, PaC□, Pa□, HC□). After the tourniquet is released, systolic and diastolic blood pressure declined immediately about 20 mmHg on both groups (A & B) of patients. It is significant (P<.05) when compared to the pressure before the tourniquet deflation. IN the group B, the pH decreased, and the PaC□ increased significantly (P,.05) after tourniquet deflation. The lactate levels elevated (P<.05) at 3-5 minutes also. There was no significant changes in the pH, PaC□ and lactate level of the patients of group A, and in the heart rate, PaO2, HC□ all patients before and after tourniquet deflation. |
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