锁骨下动脉损伤及创伤性假性动脉瘤的外科治疗策略  

The methods of surgical therapy in patients with injury of subclavian artery and traumatic pseudoaneurysm

作　　者：万圣云[1] 宋海屏[1] 余昌俊[1] 葛建军[2] 

机构地区：[1]安徽医科大学第一附属医院普通外科,安徽合肥230022 [2]安徽医科大学第一附属医院胸心外科,安徽合肥230022

出　　处：《安徽医药》2005年第3期185-186,共2页Anhui Medical and Pharmaceutical Journal

摘　　要：目的　探讨锁骨下动脉损伤及创伤性动脉瘤外科治疗措施。方法　对 2例锁骨下动脉损伤, 5例锁骨下假性动脉瘤实施了外科手术,根据病变的部位、程度及受伤时间、累及范围等,选用锁骨上、下切口,胸骨正中切口、左胸书本型切口等,采用了血管缝扎、血管壁修补,血管吻合,血管移植、辅助体外循环及球囊止血技术。结果　5例痊愈、1例动静脉狭窄, 1例动脉闭塞伴臂丛损伤,平均失血 800ml。结论　锁骨下动脉损伤及假性动脉瘤手术复杂,术前对病变进行仔细评估,选择合理的切口及手术方法是减少并发症的关键。Aim To investigate the methods of surgical therapy in patients with injury of subclavian artery and traumatic pseudoaneurysm. Methods Two patients with injury of subclavian artery and five patients with the traumatic pseudoaneurysm underwent surgical therapy. According to the location, severity and extension of the trauma, the incision is via supraclavicular, infraclavicular, median sternum or a left thoracic “book” et al. The operation adopted artery litigation without reconstruction, vessel wall repair, end-to-end anastomosis or Dacron graft interposed. Two case underwent assisted extracorporeal circulation and balloon catherter controlling hemorrhage. Result The operation is successful in five cases. One patient developed stegnosis in subclavian artery and venous, the other patient who had legated the artery developed arterial occlusion accompany with injury of brachiplex. The average loss of blood is 800 ml. Conclusions Operation of sublavian artery injury and pseudoaneurysm is very complicated. The overall assessment of trauma in pre-operation is very important. The selection of incision and the method of operation are the key in reducing the complicationof operation.

关 键 词：锁骨下动脉损伤 切口 外科治疗 创伤性假性动脉瘤 并发症 止血技术 痊愈 策略 平均 评估 

分 类 号：R654.3[医药卫生—外科学] R683[医药卫生—临床医学]