Application Research Of The Tourniquet Pressure

ObjectiveThis research aimed to explore the effect of the tissue blood perfusion evaluating the arteries were blocked at different degrees, and evaluate the clinical hemostatic effect of tourniquet pressure set on the basis of limb occlusion pressure in order to establish the foundation for the safer and more effective tourniquet pressure.Method1 Observe the tissue blood perfusion when the canine limb arteries were blocked respectively at 100%,90%,75%,50%and 25%degrees by tourniquet.2 Self-control designs were used. Tourniquet was tied at the root of left lower extremities of 7 health volunteers, and then tourniquet pressure set on the basis of limb occlusion pressure and traditional pressure. Observe the nail fold microcirculation, tissue blood perfusion, skin temperature of the distal limb and use the VAS to evaluate the subjective feeling of volunteers.3 12 patients with total knee arthroplasty were randomly divided into two groups. In one group tourniquet pressure was set on the basis of limb occlusion pressure, in the other group tourniquet pressure was set on the traditional pressure. To observe the hemostatic effect, the tissue blood perfusion and skin temperature of the distal limb, compare the blood pressure, heart rate and PETCO2 pre and post deflation tourniquet, and the tourniquet injury.Result1 There was significant statistical difference in the tissue blood perfusion when the canine limb arteries were blocked at different degrees by tourniquet. The tissue blood perfusion decreased with increasing arteries blocked degree.2 In the health volunteers, the nail fold microcirculation was stopped between limb occlusion pressure level and traditional pressure level (P=0.2116). There was no statistical difference in the tissue blood perfusion between two levels. There was significant statistical difference in the skin temperature between two levels (P=0.0144), the skin temperature of limb occlusion pressure level was higher than of traditional pressure level. There was significant statistical difference in the VAS between two levels (P=0.0041), the VAS of limb occlusion pressure level was lower than of traditional pressure level.3 In the surgical patients, there were no statistical difference in wound anatomy score, blood loss and tourniquet injury between limb occlusion pressure group and traditional pressure group. There was significant statistical difference in the tissue blood perfusion between two groups (P=0.0485), the tissue blood perfusion of limb occlusion pressure group was higher than of traditional pressure group. There was no statistical difference in the skin temperature between two groups, but the skin temperature had descending trend in the same group. There was no statistical difference in the blood pressure, heart rate and PETCO2 pre and post deflation tourniquet between two groups, but the blood pressure was decreased and the heart rate was increased post deflation tourniquet in the same group.Conclusion1 The tissue blood perfusion has high sensitivity when the canine limb arteries were blocked at different degrees by tourniquet. It can give reference for observation the hemostatic effect and body injury when the tourniquet was inflated at different pressures.2 In the health volunteers, tourniquet pressure set on the basis of limb occlusion pressure could block the blood flow. The decreased degree of skin temperature, the pain degree of extremities and the discomfort feeling were lower.3 In the patients with total knee arthroplasty, tourniquet pressure set on the basis of limb occlusion pressure had an ideal hemostatic effect and the body injury was lower. So this tourniquet pressure is safer and more effective and more appropriate than traditional pressure in clinical practice.