Application And Basic Research Of External Compression Hemostasis Technology For Inguinal Hemorrhage Caused By War Wounds Based On Tension Band Principle

Objective Massive hemorrhage in the groin area is a serious injury that is life-threatening during the war and peacetime.However,due to its special anatomical location,traditional tourniquet and manual pressure are difficult to achieve effective and lasting pressure in this area.Therefore,massive hemorrhage in the groin area has become a difficulty in pre-hospital emergency treatment and on-site treatment.However,prolonged and high-intensity compression of the bleeding artery near the heart will lead to severe arterial injury,which will bring difficulties for later arterial anastomosis and limb salvage.Therefore,it is extremely important to minimize the pressure above the artery while the groin is completely pressed to stop bleeding.The purpose of this experiment is to explore the factors that affect this pressure value.To verify the reliability of external compression hemostasis technology for inguinal hemorrhage caused by war wounds based on Tension Band Princple.Provide data and technical support for the development of new tourniquets.Methods 1.Correlation analysis between occlusive pressure of external iliac artery and observation indexes.Sixty-nine subjects were selected to obtain their blood pressure,thigh root diameter and BMI.The distal end of the external iliac artery was located near the midpoint of the inguinal ligament using an ultrasonic diagnostic instrument.The inner diameter of the blood vessels,the peak velocity of the flow,and the thickness of the upper soft tissue were measured,and the skin above them was marked.The membrane pressure sensor(diameter:1cm)was fixed in the center of the ultrasonic probe sensor surface,with the marker as the center,along the direction of the external iliac artery,and the ultrasonic probe(width:1cm,length:5cm)was used to vertically pressurize the distal end of the external iliac artery.The pressure above the artery is obtained when the artery is completely blocked.Single factor correlation analysis and multiple linear regression analysis were performed to determine the influence index.2.Measurement and analysis of the pressure required for blocking the external iliac artery with curvilinear gauze external compression.Twenty-six subjects were selected and the thin-film pressure sensor was fixed at the intersection of the inguinal ligament and the external iliac artery.The distal end of the external iliac artery was vertically pressurized by the curvilinear gauze blocks of different widths with the intersection as the center.When popliteal blood flow disappears,stop applying pressure and record the value.This value is converted to the pressure value after the test.One-way anova and paired t test were used to analyze the data.3.Feasibility and reliability study of external compression hemostasis for traumatic inguinal hemorrhage based on the tension band principle.Twenty eligible male military personnel were randomly selected as subjects.The existing hemostasis products in the army rely on this technology to perform compression bandage on the intersection of the inguinal ligament and the external iliac artery to calculate the success rate of blocking the distal iliac artery blood flow.All the above experiments were performed on both groins.Results 1.Correlation analysis between the occlusive pressure of the external iliac artery under the ultrasound probe and the observation indicators.Univariate correlation analysis showed that the peak velocity and systolic blood pressure were correlated with the occlusion pressure of the external iliac artery under the ultrasound probe(R=-O.213,P=0.012;R=0.191,P=0.025).Multiple linear regression analysis showed that the peak velocity and systolic pressure were correlated with the occlusive pressure of the external iliac artery under the ultrasound probe(P=0.02,P<0.01).2.Measurement and analysis of the pressure required for blocking the external iliac artery with curvilinear gauze external compression.The pressure above the artery required by the curvilinear gauze block with a width of 1cm,3.5cm,6cm and 8.5cm to close the distal end of the external iliac artery was 91.54 11.14mmhg,56.19 8.49mmhg,56.318.38mmhg,57.15 8.01mmhg,respectively.One-way anova was performed for the pressure required by the curve gauze blocks with a width of 3.5cm,6cm and 8.5cm,and the difference was not statistically significant(P=0.8 10).Paired t-test was performed for the pressure required by the curvilinear gauze blocks with a width of 1 cm and the pressure required by the curvilinear gauze blocks with other widths,and the difference was statistically significant(all P<0.001).3.Feasibility and reliability study of external compression hemostasis for traumatic inguinal hemorrhage based on the tension band principle.Using the existing hemostasis products of the army,external compression hemostasis technology for traumatic inguinal hemorrhage based on the tension band principle was used to block the blood flow at the distal end of the external iliac artery.Only one of the subjects had to stop the experiment due to no pain.The success rate of the experiment reached 95%Conclusions When the flow rate is normal,the higher the sytolic pressure and the smaller the peak flow rate,the higher the pressure above the artery required by the ultrasonic probe to close the distal end of the external inguinal iliac artery,and the more difficult it is to achieve hemostasis through external compression When the width of the curved gauze is greater than or equal to 3.5cm,the pressure above the artery required to block the blood flow of the external iliac artery is the minimum,suggesting that the width of the tourniquet compression module should reach 3.5cm.The technique of external compression hemostasis for traumatic inguinal hemorrhage based on tension band theory is feasible and reliable...