锁骨下动脉损伤及创伤性假性动脉瘤手术方法探讨  

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] 高涌[3] 余朝文[3] 

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 [3]蚌埠医学院附属医院血管外科

出　　处：《中国实用外科杂志》2006年第3期217-218,共2页Chinese Journal of Practical Surgery

摘　　要：目的探讨锁骨下动脉损伤及创伤性动脉瘤的外科治疗方略。方法1991～2005年对2例锁骨下动脉损伤,6例锁骨下假性动脉瘤根据病变的部位、程度及受伤时间、累及范围等选择手术入路,采用血管缝扎、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实施手术。结果6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。Objective 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 six patients with the traumatic pseudoaneurysm were underwent surgical therapy. According to the location, severity and extension of the trauma, the incision was via supraclavicular, infraclavicular, median sternum or a left thoracic ＂open book＂ etc. The operation adopted artery litigation with reconstruction, vessel wall repair, end-to-end anastomosis or Dacron graft interposed. Two cases were underwent assisted extracorporeal circulation and balloon catheter controlling hemorrhage. Results The operation was successful in six cases. One patient developed stegnosis in subclavian artery and venous, another patient who had legated the artery developed arterial occlusion accompany with injury of brachiplex. The average loss of blood was 800 mL. Conclusion Operation of suhclavian artery injury and pseudoaneurysm is very complicated and the overall assessment of trauma before operation is very important. The selection of incision and the method of operation are the key factors in reducing the complication of operation.

关 键 词：锁骨下动脉损伤 假性动脉瘤 

分 类 号：R6[医药卫生—外科学]