血管内止血带的命名及其在战创血管伤救治中的创新应用-《中国临床神经外科杂志》

文章信息/Info

Title:: Nomenclature and innovative applications of intravascular tourniquets in the treatment of vascular injuries resulting from combat or trauma

作者:: 马廉亭; 谢天浩; 徐峰; 徐召溪; 黄河; 秦杰; 赵曰圆; 安学锋; 马生辉; 430070 武汉，中国人民解放军中部战区总医院神经外科（马廉亭、谢天浩、徐召溪、黄　河、秦　杰、赵曰圆、安学锋、马生辉），骨科（徐　峰）

Author(s):: MA Lian-ting¹; XIE Tian-hao¹; XU Feng²; Xu Zhao-xi¹; HUANG He¹; QIN Jie¹; ZHAO Yue-yuan¹; AN Xue-feng¹; MA Sheng-hui¹; 1. Department of Neurosurgery, General Hospital of Central Theater Command, PLA, Wuhan 430070, China; 2. Department of Orthopedics, General Hospital of Central Theater Command, PLA, Wuhan 430070, China

Keywords:: Vascular injuries in warfare; Intravascular tourniquet; Clinical application

摘要:: 手术时，为了减少血管病变或血供丰富病变的出血，先解剖出病变上游供血动脉，在供血动脉外用橡皮带或软布带阻断血流、控制出血，然后进行手术。这个控制血流的橡皮或软布“带”称为止血带，因在血管外使用，可称“血管外止血带”。当血管病变或血供丰富的肿瘤病变位置深在或邻近颅底、躯干大血管，术中无法解剖出病变上游血管，不能用“血管外止血带”阻断血流时，我们经皮穿刺股动脉，在电视监视下，将5F或2F双腔球囊导管送至病变上游动脉，再用造影剂充盈球囊以完全阻断血流，可以代替“血管外止血带”，称为“血管内止血带”。本文总结“血管内止血带”在战创血管伤救治中的应用经验，以共临床参考。

Abstract:: During surgery, to minimize bleeding from vascular lesions or those with abundant blood supply, the upstream feeding artery of the lesion is dissected initially. Subsequently, blood flow is blocked and bleeding is controlled by applying a rubber band or soft cloth band outside the feeding artery before commencing the operation. This rubber or soft cloth band utilized for controlling blood flow is termed a tourniquet. Since it is employed outside the blood vessel, it can be designated as an "extravascular tourniquet". When the vascular lesion or tumor lesion with rich blood supply is situated deeply or in proximity to the base of the skull or major blood vessels of the trunk, and the upstream blood vessel of the lesion cannot be dissected during the operation, rendering the "extravascular tourniquet" inapplicable for blocking blood flow, we perform a percutaneous puncture of the femoral artery and send a 5F or 2F double-lumen balloon catheter to the upstream artery of the lesion under TV surveillance. Then, the balloon is filled with contrast agent to completely obstruct the blood flow, which can substitute the "extravascular tourniquet" and is referred to as an "intravascular tourniquet". This paper summarizes the application experience of the "intravascular tourniquet" in the treatment of vascular injuries resulting from combat or trauma for clinical reference.