无骨折闭合性四肢主干动脉损伤的早期诊断及治疗  

Early Diagnosis and treatment of the closed major artery injuries with no fracture in the extremities

作　　者：曹群华 缪玉龙 朱文华 祝伟 袁晓东 

机构地区：[1]江苏省扬州大学附属常熟市第二人民医院手外科,江苏常熟215500

出　　处：《实用手外科杂志》2010年第3期198-199,共2页Journal of Practical Hand Surgery

摘　　要：目的研究无骨折闭合性四肢主干动脉损伤的早期诊断和治疗。方法1998年5月一2008年7月，对24例无骨折闭合性四肢主干动脉损伤的患者，在入院后，进行体格检查，结合脉搏血氧饱和度监测仪监测，做出早期诊断，并急诊手术探查，修复损伤动脉。结果23例均一次修复成功，1例术后发生栓塞，术后4h再次探查修复后，动脉获得通畅。术后随访6个月～2年。22例患肢血液循环恢复良好，肢体功能恢复满意。1例经2次手术后，出现中度缺血性肌挛缩，1例合并肘关节半脱位的患者出现轻度肘关节伸直障碍。结论体格检查结合脉搏血氧饱和度监测仪监测，可对无骨折闭合性四肢主干动脉损伤做出早期诊断，及时修复损伤动脉，是挽救受伤肢体，减轻伤残的有效手段。Objective To study the early diagnosis and treatment of closed major artery injuries with no fracture in the extremities. Methods From May 1998 to July 2008, 24 patients with closed major artery injuries with no fracture in the extremities were treated in our hospital. After admission, the diagnosis was established by physical examination and using pulse oxygen saturation monotor. The patients received emergency operation to reconstruction of the injured arteries. Results Patency of the reconstructed arteries was achieved in all cases. In 22 extremities, good function and blood supply were obtained. In one case, arterial thrombosis occurred and patency of the artery was achieved after revision 4 hours after the primary operation. The followed-up period ranged 6 months to 2 years. At the final follow-up, moderate muscle contracture of the extremity developed due to ischemia in one patient who underwent the secondary operation. Mild extension lag of the elbow occurred in one case due to subluxation of the joint. Conclusion Physical examination and pulse oxygen saturation monitoring are critical for early diagnosis of the closed major artery injuries with no fracture in the extremities. Salvage of the injured extremity therefore can be expected.

关 键 词：动脉损伤 诊断 治疗 

分 类 号：R654.4[医药卫生—外科学]