医源性腹部主干静脉损伤的原因分析与预防  

Cause analysis and preventive measures of iatrogenic abdominal main trunk vein injury

作　　者：文刚 涂从银 杨文奇[2] 孟翔凌[2] 徐阿曼[2] 何磊 

机构地区：[1]安徽医科大学第三附属医院普外科,合肥230061 [2]安徽医科大学第一附属医院普外科,230022

出　　处：《齐齐哈尔医学院学报》2014年第8期1114-1116,共3页Journal of Qiqihar Medical University

基　　金：安徽省合肥市科技局重大课题(2008-46;2010-25)

摘　　要：目的总结腹部手术医源性主干静脉损伤的原因及预防措施。方法回顾分析59例腹部手术主干静脉损伤的临床资料,分析原因并总结预防措施。结果 59例损伤主干静脉包括右肝静脉、下腔静脉、门静脉、肠系膜上静脉、脾静脉、肾静脉、左髂静脉、髂内静脉,行静脉修补23例,人工血管移植3例,人造血管补片修补2例,静脉结扎5例,脾脏切除23例,其中56例术后恢复良好,1例出现门静脉高压、腹水,2例术后死亡。结论腹部主干静脉损伤以肿瘤手术为主,术前充分评估肿瘤与静脉的毗邻关系,术中高度重视、规范操作、解剖清楚是降低腹部肿瘤手术医源性主干静脉损伤的关键。Objective To summarize the reason and preventive measures of iatrogenic abdominal main trunk vein injury in abdominal operation. Methods Retrospective analysis of clinical data of 59 cases with iatrogenic abdominal main vein injury in abdominal operation, analyze the causes and the prevention measures are put forward. Results 59 cases main vein injury involved inferior vena cava, portal vein, superior mesenteric vein, spleeny vein, the left iliac vein, internal iliac vein. Among 59 cases, 23 cases underwent single vein repaired, Artificial vascular grafts 3 cases, 2 case synthetic material repaired, Vein ligation 5 cases, 23 cases underwent splenectomy. 56 cases of postoperative recovery were well. 1 patient with portal hypertension as cites. 2 patients died after operation. Conclusions Iatrogenic abdominal main trunk vein injury mainly occurs in abdominal tumor operation. A full assessment of preoperative proximity to the tumor and the vein, attaches great importance to surgery, standardized operation, the anatomy is clearly the key to reducing iatrogenic trunk vein injury in abdominal cancer surgery.

关 键 词：主干静脉 医源性损伤 腹部手术 预防 

分 类 号：R654.3[医药卫生—外科学]