目的探讨止血带个体化压力设定在高血压病患者上肢手术中的应用效果。方法选取该院收治的有高血压病病史的手外伤患者60例,分成Ⅰ组、Ⅱ组和Ⅲ组,每组20例。将患者术前3次血压的平均值作为基础血压,Ⅰ组为使用常规止血带压力组,Ⅱ组为收缩压基础上施加50mm Hg,Ⅲ组为收缩压基础上施加75mm Hg。观察三组患者上肢周径、基础压力、术中平均收缩压值、止血效果满意度及术后并发症。结果不同组别患者上肢周径、基础压力与术中平均收缩压值两两比较差异均无统计学意义。Ⅰ组、Ⅲ组患者止血效果满意度均明显高于Ⅱ组;Ⅰ组患者皮肤变化率、区域疼痛发生率较Ⅱ组、Ⅲ组高。结论对高血压病患者予以增加止血带压力可获得较满意的止血效果,在减少患者术后并发症的前提下,收缩压基础上增加75mm Hg是较合适的止血压力条件。 Objective To explore the application effect of tourniquet individualized pressure setting in upper limb surgery of patients with essential hypertension. Methods 60 cases of hand trauma patients with hypertension history admitted to our hospital were divided into Ⅰ, Ⅱ and Ⅲ groups, 20 cases in each group. The mean blood pressure before operation was taken as the baseline blood pressure. The patients in group Ⅰ received conventional tourniquet pressure, group Ⅱ received systolic pressure 50 mm Hg, and group Ⅲ received systolic pressure 75 mm Hg. The upper limb circumference, basic pressure, average systolic pressure, hemostatic satisfaction and postoperative complications were observed in the three groups. Results There was no significant difference in the upper limb circumference, basal pressure and mean systolic blood pressure between different groups. The satisfaction degree of hemostatic effect in group Ⅰ and group Ⅲ was significantly higher than that in group Ⅱ. The change rate of skin and regional pain in group Ⅰ were higher than those in group Ⅱ and Ⅲ. CONCLUSIONS: Increasing the tourniquet pressure in hypertensive patients can achieve a satisfactory hemostatic effect. Under the precondition of reducing the postoperative complications, an increase of 75 mm Hg on the basis of systolic blood pressure is more suitable for the treatment of hemostasis.