52例下肢大血管损伤的诊治  

Diagnosis and treatment of the large vascular injuries of the lower limbs in 52 cases

作　　者：胡建华[1] 苟景跃[1] 李邦春[1] 陈维庭[2] 

机构地区：[1]重庆市急救医疗中心骨科,400014 [2]重庆市急救医疗中心普通外科,400014

出　　处：《中华创伤杂志》2001年第10期589-591,共3页Chinese Journal of Trauma

摘　　要：目的　总结下肢大血管损伤的诊治经验。　方法　 1994年 5月～ 2 0 0 0年 12月收治下肢大血管损伤 5 2例 ,ISS - 90评分 9～ 2 6分 ,平均 13分。Ⅰ期血管吻合 39例 ,其中自体静脉移植6例 ,血管端 -端吻合 2 2例 ;血管修补 6例 ,切开取血栓 5例 ,结扎 2例。　结果　术后随访 3个月 ,47例下肢循环良好 ,其中 39例按Whitman分级为好 (伤肢行走不用支具 ) ,8例因神经损伤及骨折因素 ,分别于伤后 6～ 12个月功能恢复良好。 5例截肢。　结论　采用多普勒技术早期诊断、正确掌握手术时机并行皮肤小切口、深筋膜充分切开减压 。Objective To report clinical experience in diagnose and treatment of large vascular injuries in the lower limbs. Methods Fifty two cases of large vascular injuries of the lower limbs from 1994 to 2000 were analyzed in this study. Maximum ISS 90 score was 26 and minimum was 9 with the average score of 13. Thirty nine cases were treated by primary vascular anastomosis, in whom 6 treated by auto vein transplantation, 6 by repair, 2 by ligation, and 5 by thrombectomy. Results Blood circulation recovered satisfactorily in 47 cases 3 months after operation, in whom 39 were classified as good according to Whitman's standard. The function was recovered in 8 cases 6 12 months after injury. Five cases were amputated. Conclusions Doppler examination is valuable to diagnose the vascular injury of the lower limbs. Multiple mini incision and fasciotomy can decrease the rate of disability and amputation.

关 键 词：下肢大血管损伤 诊断 治疗 深筋膜切开术 病例报告 

分 类 号：R654.4[医药卫生—外科学] R658.3[医药卫生—临床医学]