四肢主干动脉损伤的诊治  

Diagnosis and treatment of arterial injury in limbs

作　　者：司春强[1] 

机构地区：[1]皖南医学院附属弋矶山医院血管外科,安徽芜湖241001

出　　处：《皖南医学院学报》2010年第1期36-38,共3页Journal of Wannan Medical College

摘　　要：目的:探讨四肢动脉损伤的诊治要点。方法:回顾性总结我科2005年9月～2009年8月23例肢体动脉损伤患者的临床资料,动脉损伤部位:桡动脉及胫后动脉各1例;肱动脉3例;腘动脉4例;股深动脉2例;股动脉9例;髂动脉3例。21例病人行开放手术治疗,2例病人行血管腔内治疗。结果:1例截肢,22例保肢成功;1例骨筋膜室综合征切开减压。3例注射毒品致股动脉假性动脉瘤患者股动脉结扎创面换药处理,伤口逐渐愈合。开放手术组中随访13例保肢者3～24个月,1例股动脉结扎术后3个月出现间歇跛行;1例腘动脉闭合性损伤合并骨折术后1年患肢功能障碍未恢复;余11例效果满意。腔内治疗2例效果良好,随访时间分别为6个月和12个月。结论:了解受伤情况,综合分析,是肢体主干动脉损伤早期诊断的关键;及时动脉重建是恢复肢体功能、避免伤残的重要手段。腔内治疗修复周围动脉损伤具有微创、安全和有效的优点。Objective： To sum up the experience of diagnosis and treatment of arterial injury in extremities. Methods： The clinical data were retrospectively analyzed in 23 patients with arterial injury in limbs between Sept. 2005 and Aug. 2009. The injured region was found in radial artery in 1 ,posterior tibial artery in 1 ,brachial artery in 3 ,popliteal artery in 4,deep femoral artery in 2,femoral artery in 9 and iliac artery in 3. Twenty-one patients underwent open surgery and 2 received endovascular therapy. Results： Amputation was performed in 1 case, but extremities were saved in 22. One case underwent fasciectomy due to osteofascial compartment syndrome. Three cases of drug users secondary to psendoaneurysm in femoral artery were given treatment by arterial ligation and wound dressings. The follow-up at intervals of 3 to 24 months in the 13 cases undergone open surgery showed that 1 occurred internfittent claudication, l failed to recover due to functional disturbance resulted from closed popliteal artery injury associated with fracture in the affected limb, and I l patients recovered well. The 2 cases with endovascular therapy al-so recovered web during the follow-up of 6 to 12 months. Conclusion： The key point to treat the artery injury in extremities should rely on earlier comprehensive knowledge and well-planed treatment program. Earlier reconstruction of the affected artery may be favorable to the recovery and save the limbs from disability. Besides, endovascular therapy may lead to minimal invasion into the arteries expect for its safety and efficacy.

关 键 词：四肢 动脉 血管损伤 腔内治疗 

分 类 号：R654.4[医药卫生—外科学]