杂交手术治疗急性周围动脉损伤(附10例报告)  

Hybrid Operation of Acute Peripheral Arterial Injury: A Report of 10 Cases

作　　者：郑志刚 何春水[2] 张丽峰[2] 刘洋[2] 曾伟[2] 刘源[2] 

机构地区：[1]武警四川省总队医院门诊部,乐山614000 [2]成都中医药大学附属医院血管外科,成都610072

出　　处：《中国现代手术学杂志》2013年第3期197-198,共2页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨杂交手术治疗急性周围动脉损伤的方法及疗效。方法回顾性分析2007年8月～2011年3月诊治的10例急性周围动脉损伤患者的临床资料,其中股总动脉损伤5例,股浅动脉上段损伤3例,股深动脉分支损伤1例,腋动脉损伤1例。治疗首先采取腔内介入方法,低压维持球囊充盈状态控制动脉破口出血。静脉复合麻醉下立即行血管探查手术,其中6例直接缝合破损血管,3例以自体大隐静脉修补损伤血管,1例股深动脉分支损伤者以弹簧圈栓塞后行患侧血肿清除手术。结果本组平均手术时间(81.0±17.9)min,平均失血(200.1±44.6)ml,术后2～3 d拔出引流管。所有患者术后患肢血液循环良好,但有不同程度肢体肿胀,未行筋膜切开减压术。本组均获随访,时间6～12个月。1例患者出现下肢间歇性跛行,其余患者恢复良好。结论杂交手术是治疗周围动脉损伤的一种很好的选择。Objective To explore the method and effect of hybrid operation for acute peripheral arterial injury. Methods The clinical data of 10 cases with acute peripheral arterial injuries underwent hybrid opera- tion were analyzed retrospectively. Interventional treatment was performed to control bleeding at first; Explora- tion of blood vessel was carried out subsequently, including direct suture of broken artery in 6 cases, blood ves- sel repair with autologous great saphenous vein in 3 cases and interventional embolization in 1 case. Results All cases were accomplished the surgery successfully. The average operative duration was （81.0 ± 17.9） mi- nutes and average blood loss was （200.1 ± 44.6） ml. Drainage tube was pulled out 2 to 3 days after the opera- tion. Blood circulation was achieved well, but swelling of limb was found at different extent in all affected ex- tremity. All cases were not underwent decompression fasciotomy. All 10 cases were followed up for 6 to 12 months. Intermittent claudication of lower extremity appeared in one case, and the other were restored well. Conclusion The hybrid operation is an ideal choice for acute peripheral arterial injury.

关 键 词：周围动脉损伤 介入治疗 杂交手术 

分 类 号：R654.3[医药卫生—外科学]