What Is Hemostasis?

When bleeding is treated in a certain way, quickly stopping the blood from flowing outward is called hemostasis. The hemostatic effect varies from person to person. Some people are fast, some are slow, and they are related to platelets.

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When bleeding is treated in a certain way, quickly stopping the blood from flowing outward is called hemostasis. The hemostatic effect varies from person to person. Some people are fast, some are slow, and they are related to platelets.

Under normal circumstances, bleeding caused by small blood vessel damage will stop within a few minutes. This phenomenon is called physiological hemostasis. Physiological hemostasis is one of the important protective mechanisms of the body, and is the result of the interaction of multiple factors and mechanisms. The hemostatic process mainly includes three processes: vasoconstriction, platelet thrombosis and blood coagulation.

Chinese name

Hemostasis

Foreign name

hemostasis

Nature

Words

Pinyin

zhixue

Brief introduction

Medical Terminology

External bleeding (traumatic bleeding)

Define hemostasis methods based on bleeding characteristics

Arterial hemorrhage: The bleeding frequency is consistent with the heart and pulse. There is an outflow, bleeding due to injury to the arteries, and bleeding is very much. At this time, you must be sent to the hospital. You need to stop the bleeding yourself before arriving at the hospital.

Bleeding from the skin: not much bleeding. Because the dermis layer of the body surface is bleeding, the wound can heal by itself. Before healing, the wound should be washed with water. If it is scratched by rusty metal, do not cover it with a towel or tissue Hemostasis. When there is little bleeding, you can heal by sitting for a while. For a long time, you can use a band-aid, cotton balls disinfected with alcohol, or sterile gauze to stop bleeding.

Accelerate the aggregation of platelets to the edges of the wound and tangle with each other, accelerate blood coagulation, and produce fibrin at the wound. Properly matched with drugs for activating blood and removing blood stasis. The blood rises and falls with the gas, and sometimes it is necessary to appropriately cooperate with the medicine that regulates the rise and fall of the Qi machine. For the treatment of various bleeding disorders. Suitable for vomiting blood,

Phenylsulfonamide (Hemostatic)

Oppression hemostasis

It is the most commonly used hemostatic method in surgery. The principle is to reduce or close the rupture of the blood vessel with a certain pressure, and then due to the slowing of blood flow, platelets, fibrin, and red blood cells can quickly form blood clots, stopping bleeding. The hemostasis can be compressed with ordinary gauze or with warm saline gauze at 40 ° C-50 ° C. The pressure needs sufficient time. Generally, it takes about 5 minutes and then gently remove the gauze, and repeat 2-3 times if necessary. Gauze can also be used to compress hemostasis. Because it may cause rebleeding and cause infection, it is not an ideal hemostasis method. However, for widespread bleeding and turbulent bleeding, if the existing methods have not been exhausted, it is a last resort. In the case of compression, packing can be used to stop bleeding to ensure the safety of life. The method is to use sterile dry gauze or bandages to pack the pressure. Do not leave a dead space at the stuffing place. Maintain proper pressure. The number of gauze and connection must be absolutely accurate and reliable when stuffing. Orderly folding must be done when stuffing. The stuffing is generally loosened and removed gradually 3-5 days after the operation, and everything is prepared to deal with the bleeding again.

Ligation hemostasis

There are two methods of simple ligation and suture ligation.

The simple ligation method is often used. During the surgical operation, firstly clamp the bleeding site or the bleeding point that has been seen. It is required to be accurate when clamping the bleeding point. It is best to succeed at one time. The thickness of the ligature should be based on the clamp. The amount of tissue and the thickness of the blood vessels are selected. When the blood vessels are thick, they should be ligated separately. When ligating, the tip of the upper vascular forceps must be rotated and raised (see Figure 13). The ligating line should completely cover the required ligated tissue. When tightening the first knot, lower the raised vascular forceps and gradually loosen it. When the knot is fully tightened, remove the forceps. It is particularly worth mentioning that the hemostatic forceps cannot be loosened too quickly, which will cause the ligation site to fall off or incomplete ligation to cause bleeding, and even more dangerous is the inaccurate ligation resulting in postoperative bleeding. Sometimes the large blood vessels need to be double ligated and repeated ligated. The two lines of the same blood vessel cannot be ligated at the same site, and they must be spaced apart. The line should not be tightened or loosened too much. , Too loose can cause ligature loosening bleeding.

Electrocoagulation hemostasis

Electrocoagulation is used to stop bleeding by using an electrocautery. The commonly used electrocautery is a high-frequency electrosurgical knife and an argon electrosurgical knife. There are unipolar electrocoagulation and bipolar electrocoagulation for the hemostatic methods. During hemostasis, the electrocautery can directly electrocauterize the bleeding point, or use a hemostat to clamp the bleeding point, and then use the electrocautery to contact the hemostat (Figure 16). The hemostat should accurately clamp the bleeding point or blood vessel. The less the tissue is clamped, the better. It is not allowed to touch other tissues to prevent burns. It can stop bleeding when it is powered on for 1-2 seconds. It can also use small forceps or Adison forceps (pointed forceps for vascular surgery) to directly clamp the bleeding point. Condensing. Electrocoagulation hemostasis is suitable for superficial small bleeding points to stop bleeding. When using, pay attention to: Before use, check whether the electric burner is faulty, whether the connection is correct, and check whether there are flammable chemicals in the room; Gauze or aspirator will clean the surgical field. After the electrocautery, the remaining surface cannot be wiped with gauze. You can only dip it with gauze to avoid the failure of hemostasis due to the scorching of blood; Contact other tissues to prevent injury; The blood diarrhea at the front of the conductive object should be scraped off at any time with a blade to avoid affecting the hemostatic effect.

Topical medicine or biological hemostasis

When bleeding is still present after sufficient hemostasis is performed on the wound surface, local hemostasis can be used. Commonly used drugs or biological products include: stasis hemostasis, epinephrine, thrombin, gelatin sponge, starch sponge, hemostatic powder, Jiefensi tablets ( gelfex), Shi Bizhi, etc., can be used for local packing, spraying, local injection and other methods, such as injecting adrenaline saline or gauze dipped in adrenaline saline at the surgical site can reduce wound bleeding and hemostasis. However, it is necessary to pay attention to monitoring the heart condition. In addition, some medical biogels currently used for local spraying also have better hemostatic effect.

Tourniquet hemostasis

For limb surgery (such as orthopedics, amputations, burns, incisions, etc.) and trauma. Its role is to temporarily block blood flow and create a "bloodless" surgical field, which can reduce blood loss during surgery and facilitate fine anatomy, sometimes as an emergency hemostasis for trauma patients. There are three methods. Generally, an inflatable pneumatic tourniquet is used to stop bleeding.

Cotton-type tourniquet hemostasis method At the proximal end of the wound, bandages, band-shaped cloth strips or triangle towels are stacked into a band shape to tighten the hemostasis. Generally used as an emergency hemostasis at the scene of trauma.

rubber tourniquet hemostasis

(1) Hemostatic method of rubber tourniquet at the root: use the rubber bands on the cuffs of waste surgical latex gloves, cut and wash, put in 75% alcohol for future use; refer to two narrow gauze pads at the root, and then use rubber bands to cross over On the gauze, use a hemostat to moderately clamp the intersection, but it should not be too tight to avoid affecting the arterial blood flow.

2) Rubber tourniquet for upper and lower extremities: The rubber tourniquet is properly tightened and stretched around the limb for 2 to 3 weeks. The end of the rubber band is pressed tightly against the other end of the rubber band. Inflatable pneumatic hemostatic bag hemostatic method: The equipment required for inflatable pneumatic hemostatic bag hemostatic method includes:

(1) Pneumatic hemostatic bag: Pneumatic hemostatic bag is similar to a sphygmomanometer cuff, and can be divided into a human pneumatic hemostatic bag and a child pneumatic hemostatic bag, an upper limb pneumatic hemostatic bag and a lower limb pneumatic hemostatic bag. Pneumatic hemostatic bag can also be divided into manual inflatable and electric inflatable hemostatic bag.

(2) Blood drive belt: The blood drive belt is made of latex, with a thickness of 1mm, a width of 10-12cm, and a length of 150cm.

Operation steps of blood drive belt

(1) First bind the pneumatic hemostatic bag. To prevent loosening, you can attach a bandage and fix it for a week;

(2) Lift the limbs after the air hemostatic bag is properly tied;

(3) Tighten and pressurize the blood pressure tape from the distal end to the proximal end;

(4) Inflate the hemostatic bag with a blood pressure band and maintain the required pressure;

(5) Loosen the drive belt.

Precautions for using a tourniquet

(1) The upper tourniquet should be accurate and wrapped around the wound. The upper limbs are on the upper third of the upper arms, the lower limbs are in the upper mid thighs, and the fingers are at the bases of the fingers. Should be padded with the skin ',

(2) The tourniquet should be tight and tight, and it is advisable to stop the bleeding at the distal end and not touch the arterial pulse. The blood supply through the loose artery is not suppressed, and the venous return is blocked, which in turn makes the bleeding worse; too tight is prone to tissue necrosis.

(3) Do not use the tourniquet for too long. Record the start time. Generally, do not relax for more than 1 to 1.5 hours and let blood flow for 5 to 10 minutes.