The Located Study Of Endovascular Tourniquets With Pelvic And Adjacent Large Vessel Injury In Battlefield

Objective:To design puncture points and temporary occlusion points according to the bleeding in pelvic of the trunk and the adjacent large vessel,and to obtain the mathematical formula between the distance from puncture points to temporary occlusion points and the height of the patient according to the image data,so as to provide theoretical guidance for further development of intravascular tourniquet design.Methods:According to the designed puncture points and temporary occlusion points,50 male patients aged 18-50 with normal vascular development who underwent 320CTA from 2015 to 2020 were retrospectively analyzed respectively.The basic data and related imaging data of the patients were collected,and the distance between the designed puncture point and the temporary occlusion point was measured by 3D reconstruction.Statistical analysis was conducted with the height of the patients and the distance,and the linear regression formula between the distance and height was obtained.Results:The designed puncture point was 2 cm below the intersection of the left and right femoral arteries and the inguinal ligament,and the temporary occlusion area was from the plane of the bifurcation of the abdominal aorta to the plane of the opening of the kidney artery.Fifty eligible males were included,aged 18-50 years old,with an average age of(32±10)years old,height of 161-183 cm and average height of(172.68±5.02)cm.The distance between puncture point of left femoral artery and the opening of the renal artery was 222.87-289.45 mm,with an average distance of(264.09±14.16)nm.There was a positive correlation between the distance and height.r=0.724.P<0.001,R2=0.525.The regression equation was Y(distance,mm)=88.349+2.041X(height,cm),F=52.978,P<0.001;The distance between puncture point of right femoral artery and the opening of the renal artery was 230.63-298.58mm,with an average distance of(268.32=14.68)mm.There was a positive correlation between the distance and heightr=0.683,P<0.001,R2=0.466.The regression equation was Y(distance,mm)=-76.27+1.996X(height,cm),F=41.917,P<0.001;The distance between puncture point of left femoral artery and the plane of the bifurcation of the abdominal aorta was 161.16-218.61mm,with an average distance of(183.28± 12.01)mm.There was a positive correlation between the distance and height,r=0.446<0.5.P<0.001.R2=0.199.The regression equation was Y(distance,mm)=0.311+1.065X(height,cm),F=11.889,P<0.001;The distance between the puncture point of the right femoral artery and the plane of the bifurcation of the abdominal aorta was 160.62-217.73 mm,with an average distance of(188.51 ± 11.41)mm.There was a positive correlation between the distance and the height,r=0.449<0.5,P<0.001,R2=0.202.The regression equation was Y(distance,mm)=12.390+1.02X(height,cm),F=12.116,P<0.001.Conclusion:Designed the puncture point(left and right femoral artery and inguinal ligament intersection point below 2 cm)to best temporary occlusion(abdominal aortic bifurcation plane to renal artery open plane in the upper abdominal aortic)the distance between the patients with height correlation,in line with the linear regression,the regression equation for,on the left:Y(mm)=2.041(cm)to 124.169 X,on the right side:Y(mm)=1.996X(cm)-112.09.