动脉血管损伤患者的腔内治疗  

Endovascular therapy for traumatic arterial injury

作　　者：周兴立[1] 尹存平[1] 郭曙光[1] 苏宏斌[1] 段丽红[1] 谢登波[1] 陈翠菊[1] 

机构地区：[1]成都军区昆明总医院血管外科,云南省昆明市650032

出　　处：《中华医学杂志》2013年第9期656-658,共3页National Medical Journal of China

摘　　要：目的探讨动脉血管损伤造成的动脉内膜损伤、假性动脉瘤及动一静脉瘘病变介入治疗的临床疗效。方法2009年lO月至2011年12月成都军区昆明总医院血管外科对24例血管损伤后造成的动脉内膜损伤、假性动脉瘤及动-静脉瘘病变，应用血管腔内介入技术，通过栓塞和支架置入等微创手段治疗。结果24例患者均采用腔内治疗，14例患者经皮穿刺手术，10例股部切口暴露股动脉穿刺手术，其中单纯栓塞3例，栓塞加覆膜支架置入2例，覆膜支架置入12例及裸支架置入7例，手术成功率100％。治疗后损伤动脉血流恢复，假性动脉瘤缩小，局部疼痛缓解，静脉压力减低。结论血管损伤后造成的动脉内膜损伤、假性动脉瘤及动一静脉瘘病变，应用血管腔内介入技术，通过栓塞和支架置入微创手段治疗，创伤小、并发症少、疗效满意，是一种值得尝试应用的治疗方法。Objective To explore the clinical efficacies of endovascular therapy for traumatic arterial intima injury, arterial pseudoaneurysm and arteriovenous fistula. Methods From October 2009 to December 2011, 24 patients of arterial intima injury, arterial pseudoaneurysm and arteriovenous fistula underwent endovascular therapy including embolism and stent implantation, etc. Results Among them, 14 patients were punctured directly and another 10 were punctured after the exposure of arteries. The interventions included embolism （ n = 3 ）, embolism plus covered stent implantation （ n = 2 ） , covered stent implantation （n = 12） and bare stent implantation （n =7）. And the surgical success rate was 100%. After endoluminal treatment, arterial blood flow recovered, arterial pseudoaneurysm shrank, local pain relieved and venous blood pressure decreased. Conclusion As an effective therapy for traumatic arterial intima injury, arterial pseudoaneurysm and arteriovenous fistula, endovascular therapy has minimal trauma, fewer eomolicatious and satisfactory outcomes.

关 键 词：栓塞 支架 血管损伤 

分 类 号：R654.3[医药卫生—外科学]