PDF(670 KB)
Clinical application of narrow elastic disposable tourniquet in liposuction reduction for lower limb lymphedema
Yuan GAO,Xiaorong QU,Hongwei ZHENG,Wenbing SHEN,Kun HAO,Lei GUAN
PDF(670 KB)
PDF(670 KB)
Clinical application of narrow elastic disposable tourniquet in liposuction reduction for lower limb lymphedema
)Objective To analyze the application effect of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema，and to provide the basis for its clinical application. Methods The retrospective analysis was conducted on the clinical data of 309 patients who underwent liposuction reduction surgery for the lower extremity lymphedema. The patients were divided into non-narrow elastic disposable tourniquet group （n=163） and narrow elastic disposable tourniquet group （n=146）. The intraoperative blood loss， rates of allogenic blood transfusion， incidence of adverse reactions related to dilation fluid into blood， incidence of blood pressure fluctuations， and preoperative and postoperative 24 h levels of hemoglobin （Hb） and albumin （Alb） of the patients in two groups were compared. Results Compared with non-narrow elastic disposable tourniquet group， the intraoperative blood loss， allogenic blood transfusion rate， and incidence of adverse reactions related to dilation fluid into blood of the patients in narrow elastic disposable tourniquet group were decreased （P<0.05）， while the incidence of intraoperative blood pressure fluctuations was increased （P<0.05）. Compared with non-narrow elastic disposable tourniquet group， the ΔHb level （preoperative Hb level-postoperative 24 h Hb level） and ΔAlb level（preoperative Alb level-postoperative 24 h Alb level） of the patients in narrow elastic disposable tourniquet group were decreased （P<0.05 or P<0.01）. Conclusion The application of narrow elastic disposable tourniquet in liposuction reduction surgery for the lower extremity lymphedema can effectively reduce the intraoperative bleeding and the need for allogenic transfusions， decrease the level of ΔAlb， and prevent the occurrence of adverse reactions related to dilation fluid into blood. However， attention should be given to the potential adverse reactions related to intraoperative circulatory fluctuations.
Narrow elastic disposable tourniquet / Lymphedema / Liposuction reduction / Adverse reaction / Intraoperative bleeding
R618
| 1 | ROCKSON S G， KEELEY V， KILBREATH S， et al. Cancer-associated secondary lymphoedema［J］. Nat Rev Dis Primers， 2019， 5（1）： 22. |
| 2 | ROCKSON S G， RIVERA K K. Estimating the population burden of lymphedema［J］. Ann N Y Acad Sci， 2008， 1131： 147-154. |
| 3 | 中华整形外科学分会淋巴水肿学组. 外周淋巴水肿诊疗的中国专家共识［J］. 中华整形外科杂志， 2020， 36（4）： 355-360. |
| 4 | 黄 成， 胡学庆. 淋巴水肿治疗的研究进展［J］. 组织工程与重建外科， 2022， 18（1）： 38-41. |
| 5 | TROTT S A， BERAN S J， ROHRICH R J， et al. Safety considerations and fluid resuscitation in liposuction： an analysis of 53 consecutive patients［J］. Plast Reconstr Surg， 1998， 102（6）： 2220-2229. |
| 6 | DEMIRKALE I， TECIMEL O， SESEN H， et al. Nondrainage decreases blood transfusion need and infection rate in bilateral total knee arthroplasty［J］. J Arthroplasty， 2014， 29（5）： 993-997. |
| 7 | 常 鲲，夏 松，孙宇光，等. 联合应用抽吸减容与淋巴静脉吻合治疗乳腺癌相关上肢淋巴水肿的疗效分析［J］.中华普通外科杂志， 2020， 35（7）： 545-549. |
| 8 | CORMIER J N， ASKEW R L， MUNGOVAN K S， et al. Lymphedema beyond breast cancer： a systematic review and meta-analysis of cancer-related secondary lymphedema［J］. Cancer， 2010， 116（22）： 5138-5149. |
| 9 | BRAHMA B， YAMAMOTO T. Breast cancer treatment-related lymphedema （BCRL）： an overview of the literature and updates in microsurgery reconstructions［J］. Eur J Surg Oncol， 2019， 45（7）： 1138-1145. |
| 10 | CARL H M， WALIA G， BELLO R， et al. Systematic review of the surgical treatment of extremity lymphedema［J］. J Reconstr Microsurg， 2017， 33（6）： 412-425. |
| 11 | CHOUDRY U H， HYZA P， LANE J， et al. The importance of preoperative hemoglobin evaluation in large volume liposuction： lessons learned from our 15-year experience［J］. Ann Plast Surg， 2008， 61（3）： 230-234. |
| 12 | 孙永强， 刘国杰， 李帅垒， 等. 驱血止血弹性束紧套环在初次全膝关节置换术中应用的疗效［J］. 实用骨科杂志， 2021， 27（3）： 199-204. |
| 13 | BOURQUELOT P， LEVY B I. Narrow elastic disposable tourniquet （Hemaclear?） vs. traditional wide pneumatic tourniquet for creation or revision of hemodialysis angioaccesses［J］. J Vasc Access， 2016， 17（3）： 205-209. |
| 14 | GE X L， DAI X J， DING C， et al. Early postoperative decrease of serum albumin predicts surgical outcome in patients undergoing colorectal resection［J］. Dis Colon Rectum， 2017， 60（3）： 326-334. |
| 15 | 饶尚锐， 潘忠良， 石 铮. 腹腔镜胆总管一期缝合术后胆漏的多因素分析： 血浆白蛋白水平是胆漏发生的独立危险因素［J］. 中国微创外科杂志， 2013， 13（11）： 982-984. |
| 16 | KINOSHITA F， TAGAWA T， YAMASHITA T， et al. Prognostic value of postoperative decrease in serum albumin on surgically resected early-stage non-small cell lung carcinoma： a multicenter retrospective study［J］. PLoS One， 2021， 16（9）： e0256894. |
| 17 | 陈余兴， 王 贵. 高龄老年骨科手术患者术后低蛋白血症风险因素及预测模型［J］. 中国老年学杂志， 2022， 42（1）： 55-59. |
| 18 | HERBST K L， KAHN L A， IKER E， et al. Standard of care for lipedema in the United States［J］. Phlebology， 2021， 36（10）： 779-796. |
| 19 | KENKEL J M， LIPSCHITZ A H， LUBY M， et al. Hemodynamic physiology and thermoregulation in liposuction［J］. Plast Reconstr Surg， 2004， 114（2）： 503-513； discussion 514-515. |
| 20 | 张海静， 赵斌江， 周 茁， 等. 罗哌卡因膨胀液在吸脂术中的应用［J］. 中国微创外科杂志， 2018， 18（7）： 604-606. |
| 21 | GIELEN M J， STIENSTRA R. Tourniquet hypertension and its prevention： a review［J］. Reg Anesth， 1991， 16（4）： 191-194. |
| 22 | SUN Y， ZHAO J H， GUO W L， et al. Single injection of lidocaine to reduce tourniquet hypertension in ambulatory arthroscopic patients under general anaesthesia： randomized， double-blind， placebo-controlled clinical trial［J］. BJS Open， 2023， 7（2）： zrad014.DOI：10.1093/bjsopen/zrad014 . |
| 23 | PINSORNSAK P， PINITCHANON P， BOONTANAPIBUL K. Effect of different tourniquet pressure on postoperative pain and complications after total knee arthroplasty： a prospective， randomized controlled trial［J］. J Arthroplasty， 2021， 36（5）： 1638-1644. |
/
| 〈 |
|
〉 |
AI Summary
